Republic of the Philippines)

City of Puerto Princesa ) S.S

Province of Palawan )

AFFIDAVIT OF LOSS

I, ________________, of legal age, Filipino, and a resident of

_____________________, after being duly sworn in accordance with law, states:

1. That I was previously issued with Philippine Postal ID Card some time in
201, the number of which I could no longer recall;

2. That I have been keeping the said Postal ID in my wallet along with my
other identifications;

3. That around March of this year, I lost my wallet when I travelled to

__________________;

4. That I took effort to look for the said wallet, but to no avail such that I
believe that it is now lost beyond recovery;

5. THAT I am executing this Affidavit to attest to the truth of the foregoing

facts and to support my application for the re-issuance of my I.D and for
whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this

_________________ at _________________.
 

Affiant

SUBSCRIBED AND SWORN to before me this _______________ at

____________________, by the Affiant whom I personally know.
 

Doc. No. ______;

Page No. ______;
Book No.______;
Series of 2022.