REPUBLIC OF THE PHILIPPINES)

CEBU CITY ) S.S.

AFFIDAVIT OF LOSS

I, ___________________., of legal age, Filipino, single, with residence at

___________________________, Cebu City, after having been sworn to in
accordance with law hereby depose and say that:

1. I am a Certified Public Accountant;

2. As such, I am a holder of a Professional Regulation Commissions (PRC)

ID issued by the Professional Regulations Commission, Cebu;

3. Said PRC ID is always in a card jacket and kept inside my pocket;

4. On or about 20 November 2022, I was surprised to find out that said card
jacket was gone.

5. The card jacket, containing my PRC ID, must have fallen from the pocket of
my jeans on my way home.

6. I took earnest efforts to look for it but to no avail, hence given up as lost;

7. I execute this affidavit to attest to the truthfulness and veracity of the

foregoing facts, and for the purpose of securing another PRC ID, and for
whatever purpose it may serve.

IN WITNESS WHEREOF, I have hereunto signed my name this ____ day

of 2022 in Cebu City, Philippines.

__________________________
Affiant

      SUBSCRIBED AND SWORN to before me this _____ day of

_____________ 2022 in Cebu City, Philippines. Affiant exhibited to me his
competent evidence of identity as __________________.

Notary Public

Doc. No____;
Page No. ___;
Book No. ___;
Series of 2022.