Republic of the Philippines) SS

City of Baguio . . . . . . . . .)

AFFIDAVIT OF LOSS

I, ROMANDO GOLMAN MANNOD, of legal age, Filipino, married, and a

resident of Batunbinongle, Bocos, Banaue, Ifugao, Philippines, after having been
sworn to under oath hereby state, that:

1. I am a member-depositor of AFPSLAI with office at Camp Allen, Baguio

City, Philippines wherein I was duly issued a green and a yellow
passbook;

2. However, sometime in 2019 while I assigned in Manuyao Fire Station if

Ifugao, I intended to get a loan from AFPSLAI but I noticed that my
said passbooks were missing as they are no longer in my files which I
realize that I may have misplaced them while I was in my office;

3. I then exerted efforts to locate the same by looking for it and asking
my colleagues but my efforts proved futile and as such, I considered
said AFPSLAI green and yellow passbooks lost beyond recovery;

4. Said AFPSLAI green and yellow passbooks were neither confiscated by

the authorities nor were they used for unlawful purpose;

5. This Affidavit is hereby executed to attest to the truthfulness of the

foregoing and for all legal intents and purposes it may serve.

Signed this 2nd day of September 2021, Baguio City, Philippines.

ROMANDO GOLMAN MANNOD

Affiant
BFP Non-Commissioned Officer ID Card No. M93054

BEFORE ME, a Notary Public for and in the City of Baguio, personally
appeared the affiant with his above-indicated ID Card as above-indicated under
his name, known to me and to me known to be the same person who executed
the foregoing.

WITNESS MY HAND AND SEAL this ___th of September 2021 at

Baguio City, Philippines.