Republic of the Philippines )

Province of Isabela ) S.S.

City of Cauayan )

AFFIDAVIT OF LOSS

I, RIECHELLE MAY UY BASE, of legal age, with residence and postal address at #37
Dalupang St., GSIS Village, Cauayan City, Isabela, after having been duly sworn in accordance
with law do hereby depose and state:

1. That I am the same person executing this affidavit;

2. That I am the issuant of a Land Transportation Office Non-Professional

Driver’s with No. B02-07-000809 with expiration date 2022/05/20;

3. That I am likewise the issuant of a Philippine Postal Corporation Postal

Identity Card with No. PRN A42180632044 P with expiration 20 Oct 21;

4. That while in Manila last October 2020, I lost my wallet containing the above
mentioned Identification Cards;

5. That I exerted efforts in locating the same but such efforts proved to be in vain
as I was not able to find the said IDs;

6. That despite such efforts, the above-mentioned Identification Cards were

nowhere to be found and are considered beyond recovery;

7. That I hereby attest the truth of the foregoing statements and based only on
my personal knowledge;

8. That I execute this affidavit to have a replacement Identification Card be

issued to under my name by the respective agencies mentioned above and for
whatever lawful purposes it may serve.

IN WITNESS WHEREOF, I have here unto set my hand this___ day of

________________ 2020, at City of Cauayan, Isabela, Philippines.

RIECHELLE MAY UY BASE

Affiant
TIN: 334-000-841-000

SUBSCRIBED AND SWORN to before me on the same date and place above-stated
herein. Affiant exhibiting her competent proof of identification.

Doc. No.____;
Page No.____;
Book No.____;
Series of 2020.