REPUBLIC OF THE PHILIPPINES)

RIZAL PROVINCE ) S.S.

AFFIDAVIT OF LOSS
I, JUAN DELA CRUZ, of legal age, single, Filipino, and a resident of Blk 1 Lot 2, Sunshine
Subdivision, Rodriguez, Rizal, after having been sworn to in accordance with law hereby depose
and say that:

1. I am a holder of a Postal ID issued by the Philippine Postal Corporation (PhilPost) in

Rodriguez, Rizal.

2. On 01 September 2020, our house was gutted by fire.

3. All my valuable items, including the Postal ID issued to me by PhilPost, were burned.

4. I was not able to save my valuable items and my Postal ID because when the fire
happened, I was at my work.

5. I execute this affidavit to attest to the truthfulness of the foregoing information, and to
secure another postal ID at PhilPost, and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of September
2020 in Rodriguez, Rizal, Philippines.

JUAN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me this _____ day of September 2020 in

Rodriguez, Rizal, Philippines. Affiant exhibited to me his competent evidence of identity as
__________________.

Doc. No____;
Page No. ___;
Book No. ___;
Series of 2020.