REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO ) S.S.

PROVINCE OF PAMPANGA )

AFFIDAVIT OF LOSS OF IDENTIFICATION CARD

That I, JOSEPH CRUZ DAVID, of legal age, Filipino, with residence and postal address at
#14 Fernhill Road., Greenfields, San Fernando, Pampanga, after having been duly sworn in
accordance with law, do hereby depose and say:

That I am a holder of a SBMA Identification Card issued by the SUBIC BAY

METROPOLITAN AUTHORITY:

That the said SBMA Identification Card, which I kept in my wallet, discovered
lost/missing, when the said wallet was nowhere to be found and I presumed it was stolen.

That I am executing this affidavit in order to attest to the truth of the foregoing
statements and to other legal intents and purposes.

AFFIDAVIT FURTHER SAYETH NAUGHT.

JOSEPH CRUZ DAVID

Affiant

SUBSCRIBED AND SWORN to before me this 18 th day of August 2020 at the City of San
Fernando, Pampanga, affiant exhibited to me his CTC No. CCI2019 15503754, issued on
February 19, 2020, at City of San Fernando, Pampanga.

Doc. No.__________________;
Page No.__________________
Book No.__________________
Series of 2020