You are on page 1of 2

REPUBLIC OF THE PHILIPPINES )

Pili, Camarines Sur ) SS.

AFFIDAVIT OF LOSS

I, WINCES BASILLA BRIGUERA, married, of legal age and residing/with address at


Mabalodbalod, Tigaon, Camarines Sur, under oath, state:

1. That on or about May of 2020 at Mabalodbalod, Tigaon, Camarines Sur, I placed my


Philippine Army pay slip for the Month of April 2020 in the filing cabinet at our house,
but when I checked the same on June 18, 2020, I cannot anymore find the same in said filing
cabinet;

2. That I exerted diligent efforts to locate said pay slip or but to no avail and I therefore
considered the same as lost and can no longer be found;

3. That I am executing this Affidavit to attest to the truth of the foregoing facts and to use the
same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this 19 th day of June 2020 at Pili,
Camarines Sur.

WINCES BASILLA BRIGUERA


Affiant

SUBSCRIBED AND SWORN to before me this 19th day of June 2020 at Pili, Camarines Sur,
Affiant exhibited to me his AFP Identification bearing Nos. 871740, issued by Philippine Army.
REPUBLIC OF THE PHILIPPINES )
Pili, Camarines Sur) SS.

AFFIDAVIT OF LOSS

I, ROWALDY DECENA GORDULA, married, of legal age and residing/with address at


Mabalodbalod, Tigaon, Camarines Sur, under oath, state:

1. That on or about May of 2020 at Mabalodbalod, Tigaon, Camarines Sur, I placed my


Philippine Army pay slip for the Month of April 2020 in my wallet. However, when I
checked the sometime in June 2020, I cannot anymore find the same in said wallet, such that
I believe said pay slip fell from my pocket;

2. That I exerted diligent efforts to locate said pay slip or but to no avail and I therefore
considered the same as lost and can no longer be found;

3. That I am executing this Affidavit to attest to the truth of the foregoing facts and to use the
same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this 19 th day of June 2020 at Pili,
Camarines Sur.

ROWALDY DECENA GORDULA


Affiant

SUBSCRIBED AND SWORN to before me this 19th day of June 2020 at Pili, Camarines Sur,
Affiant exhibited to me his AFP Identification bearing Nos. 874374, issued by Philippine Army.

You might also like