Republic of the Philippines)

La Trinidad, Benguet) s.s

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AFFIDAVIT OF LOSS OF AUTOMATED TELLER MACHINE CARD

I, Rovabel B. Guanso, of legal age, married, Filipino, and currently a resident of

Ambabag, Guinaoang, Mankayan, Benguet, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state THAT:

1. I am an account holder of Development Bank of the Philippines (DBP)-Session Road

Baguio City since 2015. As such, I was issued a DBP Automated Teller Machine
(ATM) Card.

2. I have kept the said ATM Card inside my wallet until it got lost/missing sometime on
September 13, 2019. The facts of the loss are as follows:

Sometime in the morning of September 13, 2019, I put my wallet containing my

DBP ATM Card and other personal items on top of my drawer inside the room at
our house. Thereafter, I went out of the room to attend to some household chores.
After an hour, I finished what I was doing. I went back inside the room where I
placed my wallet afore-mentioned. Upon entering our room, I saw my 3-year old
son playing with my wallet with all its contents already scattered around. I
immediately took the wallet from him and started gathering the contents which
were scattered. After a while, I noticed that my DBP ATM Card was not there. I
therefore took a second look and checked again the items. It was then and there
that I confirmed said ATM Card was missing. I immediately searched inside the
premises and even asked my housemates about the same but was unable to find it
until now despite continuous efforts exerted to find the same.

3. In view of the foregoing, I strongly believed that my said DBP ATM Card has been
inadvertently lost without any deliberate intent on my part whatsoever, therefore, I
consider it lost and beyond recovery;

4. Said ATM Card has not been used for any illegal activities nor confiscated by any
government authorities but due to the afore cited reason;

5. Finally, I am executing this affidavit to attest to the truthfulness of the foregoing facts
and for all legal intents and purposes it may serve well.

IN WITNESS WHEREOF, I have hereunto set my hand this ______________ at La

Trinidad, Benguet, Philippines.

Rovabel B. Guanso
Affiant
GSIS ID No. 2004790651
TIN 407-805-633

SUBSCRIBED AND SWORN to before me a Notary Public for and in La Trinidad,

Benguet, Philippines this ____________ by the above Affiant exhibiting to me her valid and
competent ID with picture above his name and identified by to be the same person who
personally signed before me the foregoing Affidavit.