REPUBLIC OF THE PHILIPPINES )

PROVINCE OF THE PANGASINAN) S.S.

MUNICIPALITY OF MANGALDAN)
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AFFIDAVIT OF LOSS

I, STEPHEN P. ALCANTARA, of legal age, Filipino citizen and a resident of

Brgy. Bari, Mangaldan, Pangasinan, after having been duly sworn in accordance with
law, hereby depose and state:

1. That I am a holder of ATM card issued by BDO Mangaldan, Pangasinan;

2. That I always keep the above-mentioned card in my wallet wherever I go;

3. That recently, I misplaced my ATM Card, in some place I could no longer

recall;

4. That despite diligent search and efforts to locate my ATM Card, I could not
find the same such that I now believe they are lost beyond recovery;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the

foregoing and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this November 7,

2022 in Mangaldan, Pangasinan.

STEPHEN P. ALCANTARA
Affiant
NPDL No. A07-20-006603

SUBSCRIBED AND SWORN to before me this November 7, 2022 in Mangaldan,

Pangasinan.

ATTY. FERNANDO JUAN A. CABRERA

NOTARY PUBLIC
UNTIL DECEMBER 31, 2022 per BM 3795
Doc. No. 395; YDIA ST. BRGY. GUILIG, MANGALDAN, PANG.
Page No. 80; IBP No. 0075/1-3-22
Book No. 19; PTR No. 8672591/1-3-22
Series of 2022. ROLL NO. 62453/TIN 429-314-607-000
SNC-NP-15-2020
MCLE Comp. No. VII-0005380, 10-26-21