Professional Documents
Culture Documents
AFFIDAVIT OF LOSS
2. That sometime on December 23, 2016, I lost my wallet where I kept the
said license and my other identification cards;
3. That despite diligent efforts to locate it, the same could no longer be
found and is deemed lost; and
4. That I am executing this affidavit to attest to the truth and veracity of the
foregoing statement;
CYRIL C. FRANCISCO
Affiant
Doc. No.____;
Page No. ____;
Book No ____;
Series of 2017
Republic of the Philippines )
Province of Aklan } S.S.
Municipality of Kalibo )
2. We know for a fact that the person by the name of “Maria Lusy
Macahilig” as appearing in her Certificate of Live Birth, the name “Luz Macahilig
Tulio” as appearing in her Social Security System (SSS) records, and the name
“Ma Luz Macahilig Tulio” as appearing in her PhilHealth records, refer to one
and the same person and that her true and correct name is Maria Lusy
Macahilig;
3. We are not in any way related to any of the foregoing person within the
fourth civil degree either by consanguinity or affinity, nor do we have any
pecuniary interest in this matter whatsoever;
IN WITNESS WHEREOF, we have hereunto set our hand this 29 th day of March,
2016 at Batan, Aklan, Philippines.
AFFIDAVIT
7. That I am executing this affidavit to attest to the truth and veracity of the
foregoing statement;
JOCELYN M. ARBOLEDA
Affiant
AFFIDAVIT
10. That I am executing this affidavit to attest to the truth and veracity
of the foregoing statement;
CYRIL C. FRANCISCO
Affiant