Republic of the Philippines )

City of Muntinlupa ) S.S.

AFFIDAVIT OF LOSS

I, GROW NAHSMAN, of legal age, Filipino, a resident of B36 Bldg 400, Putatan,
Muntinlupa City, after having been sworn to in accordance with law, do hereby depose
and state that:

1. I was issued a Philippine Passport with Number EB97845821 by the

Department of Foreign Affairs on 03 December 2013. Said passport expired
on 02 December 2018;

2. Since my passport is already expired, I intend to renew the same in

preparation for an upcoming trip outside the Philippines;

3. It was only on 25 May 2023, after a thorough search, that I found out that
my passport is not in the place where I thought to have safekept it;

4. I have exerted earnest efforts in locating my passport but to no avail. Thus,

the said passport is already lost beyond recovery for all intents and purposes;

5. I am executing this affidavit to attest to the truth and veracity of the

foregoing and to support my application for a new Philippine Passport from
the Department of Foreign Affairs.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_________________ in Muntinlupa City.

GROW NAHSMAN Affiant

SUBSCRIBED AND SWORN to before me this _____________________ in

Muntinlupa City, affiant exhibiting to me his Driver’s License with No.
_________________________ valid until ______________________.