REPUBLIC OF THE PHILIPPINES

_________________, Metro Manila

AFFIDAVIT OF LOSS OF COMPANY ID

I, LORRAINE DEEM FLAMENIA, Filipino, of legal age, single, and a resident of #10
Orchid St., Superville SB, Sucat, Parañaque City, having been duly sworn in accordance with
law, hereby depose and state:
1. That I lost my Company ID issued under my name by Philippines Air Asia
Corporation on or about October 3, 2020 when I misplaced the said ID due to
inadvertence and unintentional cause;
2. That said ID is not confiscated by authorities nor used for illegal or unauthorized
means and purposes;
3. That notwithstanding the earnest effort to locate the said ID, it remains unlocated to
this day;
4. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support the application for the issuance of a new ID for purposes allowed by
the company and the law.

IN WITNESS WHEREOF, I have hereunto set my hand this _____day of ______ 2020,
at _________________ Metro Manila, Philippines.

LORRAINE DEEM FLAMENIA

Affiant

SUBSCRIBED AND SWORN to before me this day of ___________, 2020, the affiant
is personally known to me and exhibiting to me her _______________________ issued at
_________________ on _______________.