REPUBLIC OF THE 

PHILIPPINES
PROVINCE OF BUKIDNON) S.S.
MUNICPALITY OF DON CARLOS
x----------------------------x
  

AFFIDAVIT OF LOSS

 I, ELPEDIO YABO LOMARDA, Filipino, of legal age, single, and a resident of

Poblacion Norte, Don Carlos, Bukidnon, Philippines, after having been duly
sworn to in accordance with law, depose and state THAT:

1. I am a holder of a passbook from Manila Teachers’ Savings and Loan

Association;

2. Sometime in the month of April, 2021, my passbook form the above-mentioned

association was lost in the cabinet where I used to place it together with some
of my pertinent documents;

3. Despite the diligent efforts exerted to search it, I could no longer locate, find or
recover the said passbook, and to the best of my knowledge, the same is truly
lost;

4. In view thereof, I now desire and hereby request the Manila Teachers’ Savings
and Loan Association to issue another passbook in lieu of the lost one and I am
willing to surrender the lost passbook in the event that the same could be
found;

5. As such, I am executing this Affidavit to attest to the foregoing facts and to

support the application for the issuance of a new passbook and in support to my
retirement claim in lieu of the one which was lost. 

IN WITNESS WHEREOF, I have hereunto set my hand this 27TH day of

May, 2021 at Don Carlos, Bukidnon, Philippines.

ELPEDIO YABO LOMARDA

Affiant
PRC ID No. 0102730

        
SUBCRIBED AND SWORN TO BEFORE ME, a notary in public and for
the Province of Bukidnon, Municipality of Don Carlos, this 27 th day of May, 2021.
Affiant personally appeared, known to me and to me known as the same person
who personally signed the foregoing instrument.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2013.