REPUBLIC OF THE PHILIPPINES

CITY OF PASIG

METRO POLITAN MANILA

AFFIDAVIT OF LOST
I, POLICE _______________________________ , LEGAL AGE, FILIPINO, and a resident
of _______________________________________.

That, on _____________________________ I.D. Card in my name;

That Sometimes on March 20, 2010 While on My Strolling with my Children at

_________ I, lost my Wallet Including my PNP I.D. and cannot be found;

That, I exerted all my diligent effort to locate the same but prove futile result.

That , I executing this affidavit to attest to the truth of the aforementioned facts and for
all legal purpose it may serve best.

IN WITNESS WHEREOF, I have hereunto set my hand this day of April 29, 2010. Pasig
City.

___________________
Affiant

SUBCRIBED AND SWORN to before me this 29 of April 2010 at Pasig City.

____________________

Administering Officer
Under RA 6975 Sec 50