REPUBLIC OF THE PHILIPPINES)

PROVINCE OF NUEVA ECIJA ) SS.

CITY OF GAPAN )
x------------------------------------------x

AFFIDAVIT OF LOSS

I, JOSE C. ELVAMBUENA, Filipino, 72 years old, widow and with post

office address at Mambangnan, San Leonardo, Nueva Ecija, under oath
hereby depose and state:

That I am a holder of ATM Card issued by LANDBank, Gapan City

Branch under Account No. 1536-9022-32;

That I have been keeping said ATM Card in my wallet together with
other equally important identifications;

That my LANDBank ATM Card contained in my wallet was lost in my

possession and despite diligent effort exerted to locate said ATM card, all
efforts proved futile;

That up to the present I have not yet found the missing ATM Card
and is now considered lost and beyond recovery;

That said ATM Card was not transferred or confiscated but was
merely lost in my possession;

That I am now executing this affidavit to request the LAND Bank,

Gapan City Branch to issue another ATM Card in lieu of the lost one with
the same validity;

That I further execute this affidavit to attest to the veracity of the

above-stated facts and for whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature 27 th

day of November, 2015 in Gapan City, Nueva Ecija.

JOSE C. ELVAMBUENA
Affiant
Senior Citizen ID No. 082015-4596

SUBSCRIBED AND SWORN to before me this 27 th day of November

2015 in Gapan City, Nueva Ecija.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF NUEVA ECIJA ) SS.
CITY OF GAPAN )
x------------------------------------------x

AFFIDAVIT OF LOSS

I, MARY GRACE V. REYES, Filipino, 33 years old, married and resident of

Brgy. Bayanihan, Gapan City, Nueva Ecija, under oath hereby depose and state:

That as member of the SSS, I am a holder of SSS ID Card with assigned

SS Number 02-21245770;

That I have been keeping said SSS ID Card in my body bag together with
other equally important identifications;

That sometime in July, 2014 I went to the SSS office in Cabanatuan City
and on my way home, I waited for a jitney in front of the Pacific Mall when
suddenly an unidentified person forcibly took away from me my body bag
containing my SSS ID and other important identifications;

That I exerted efforts in looking for said SSS ID Card and even asked the
help of the people in the vicinity, but all our efforts were in vain;

That up to the present I have not yet found the missing SSS ID Card and
is now considered lost;

That said SSS ID Card was not transferred, encumbered but was merely
lost in my possession;

That I am now executing this affidavit to request the SSS to issue another
SSS ID Card in lieu of the lost one, after payment of the prescribed fees;

That I further execute this affidavit to attest to the veracity of the above-
stated facts and for whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6 th day

of August, 2014 in Gapan City, Nueva Ecija.

MARY GRACE V. REYES

Affiant
Gapan City Gov’t. ID No. 13682

SUBSCRIBED AND SWORN to before me this 6th day of August, 2014 in

Gapan City, Nueva Ecija.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF NUEVA ECIJA ) SS.
CITY OF GAPAN )
x------------------------------------------x

AFFIDAVIT OF LOSS

I, ROMEO REYES PASCUAL, Filipino, 42 years old, married and with

post office address at San Lorenzo, Gapan city, Nueva Ecija, under oath
hereby depose and state:

That I am a holder of ATM Card issued by AUB Bank, Gapan City

Branch under Account No. 7332;

That I have been keeping said ATM Card in my wallet together with
other equally important identifications;

That last November 15, 2015 my AUB Bank ATM Card contained in
my wallet was lost in my possession and despite diligent effort exerted to
locate said ATM card, all efforts proved futile;

That up to the present I have not yet found the missing ATM Card
and is now considered lost and beyond recovery;

That said ATM Card was not transferred or confiscated but was
merely lost in my possession;

That I am now executing this affidavit to request the AUB Bank,

Gapan City Branch to issue another ATM Card in lieu of the lost one with
the same validity;

That I further execute this affidavit to attest to the veracity of the

above-stated facts and for whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature 18 th

day of November, 2015 in Gapan City, Nueva Ecija.

ROMEO REYES PASCUAL

Affiant
PNP Security Guard License Card presented

SUBSCRIBED AND SWORN to before me this 18 th day of November

2015 in Gapan City, Nueva Ecija.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF NUEVA ECIJA ) SS.
CITY OF GAPAN )
x------------------------------------------x

AFFIDAVIT OF LOSS

I, ARNEL SAN PEDRO REYES, Filipino, of legal, married and with

post office address at Brgy. Marelo, Gapan City, Nueva Ecija, under oath
hereby depose and state:

That I am an employee of the Baliwag Bus Company as Bus

Conductor and was required to deposit Cash Bond in the amount of One
Thousand Five Hundred (Php.1,500.00) Pesos;

That I was issued corresponding Official Receipt for my cash bond

deposit and I kept said official receipt in my wallet together with other
important receipts and identification;

That sometime in 2014 my wallet containing the Official Receipt for

my Cash Bond deposit at the Baliwag Bus company was lost in my
possession and despite diligent effort exerted to locate said my wallet
containing said Official Receipt, all efforts proved futile;

That I am now executing this affidavit to inform the Baliwag Bus

company employee concerned about the lost of the Official Receipt for my
cash bond deposit;

That I further execute this affidavit to attest to the veracity of the

above-stated facts and for whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature 4 th

day of June, 2015 in Gapan City, Nueva Ecija.

ARNEL SAN PEDRO REYES

Affiant
SSS ID NO. 02-1653165-1

SUBSCRIBED AND SWORN to before me this 4th day of June 2015

in Gapan City, Nueva Ecija.