REPUBLIC OF THE PHILIPPINES )

CITY OF MANILA ) S.S.

AFFIDAVIT OF LOSS

I, JAVIER DELOS SANTOS, Filipino, Single and with address at 1274

C. Gov St. Sta Cruz, Manila after being duly sworn in accordance with law,
hereby deposes and states that:

1. I am a holder of Security License with Nr: NCR2023645435 issued

by Supervisory Office for Security and Investigation Agencies (SOSIA);

2. I used to put the said Identification card inside my wallet;

3. On May 11, 2023 at around 11:30 AM, while I was riding in a

tricycle I suddenly notice that I lost my wallet which I usually place in
my back pocket;

4. Despite diligent effort exerted, I could not find nor locate my wallet
and now considered lost and beyond recovery;

5. The said ID has not been confiscated by any officer of the law or the
issuing office or agency due to the violation of any law, statute, order,
rule or regulation;

6. I am executing this Affidavit in order to attest to truth of the

foregoing and for all legal intents and purposes.

AFFIANT FURTHER SAYETH NAUGHT.

JAVIER DELOS SANTOS

Affiant

SUBSCRIBED AND SWORN to me before this 25th day of May 2023,

in the City of Manila, affiant presented his Postal ID PRN: 0429534023 valid
until 08 February 2025.

Doc No. ________

Page No. _______
Book No. _______
Series of 2023