Republic of the Philippines)

DONE: CITY OF BAGUIO…..) SS.

AFFIDAVIT OF LOSS
I, LORNA AVILA CEA, of legal age, single, Filipino Citizen, with residence and postal
address at No. 8, Purok Arupong, Loakan Proper, Baguio City, Philippines, after having been
duly sworn to in accordance with law do hereby deposes and states, that:

1. I am a holder of a BIR Tax Identification Number Card, PhilHealth ID Card and

a cellular phone, Vivo Y59, bearing SIM Card No. 09614909519;

2. I always kept my aforesaid belongings in a sling/shoulder bag. I am a vendor at the

City Market and on May 11, 2023 at around 3:30 o’clock in the morning, I displayed
my dry goods at Kayang-Hilltop and just hang my bag on a certain place, which I
usually do. After a several minutes of being busy selling goods, I checked my bag and
I noticed that it was no longer in the place where I hanged it;

3. I thought that my co-vendor who was also selling her goods beside mine kept it,
however, she said no. I and my co-vendors helped me to locate my bag, however, we
failed. Despite of our exerted diligent effort to find the said bag, still we did not find
it, hence, it is considered forever lost. Maybe it was taken by unidentified person
because if it was just misplaced, then we could have found it;

4. The said BIR Tax Identification Number Card, PhilHealth ID Card and a
cellular phone with CP No. 09614909519 have not been given nor pledged to
anyone for any purpose whatsoever, nor were taken nor confiscated by the authorities
for any violation of banking rules and regulations;

5. I am executing this affidavit to attest to the truth of my foregoing statements, to

support my request for the issuance of a new BIR TIN Card and PhilHealth ID
Card in lieu of the lost one, and for the blocking of the CP No. 09614909519, and
for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 12th day of May, 2023, at
Baguio City, Philippines.

LORNA AVILA CEA

AFFIANT

SUBSCRIBED AND SWORN TO before me this 12th day of May, 2023, at Baguio City,
Philippines. Affiant personally appeared and to be the same person who executed this instrument
as her free act and deed.

Doc. No. ____________;
Page No. ____________;
Book No. 66;
Series of 2023.
MODESTO T. ANDONG
Notary Public
Comm. N.A.-56-NC-22-R until Dec. 31, 2024
PTR No. 4902764/1-04-2023
IBP OR No. 271717/1-5-2023
ROLL No. 31289/5-15-81/Manila
BIR TIN No. 121-017-652-000
MCLE Comp. No. VII-0025907/Valid Until: April 14, 2025
ANDONG and NEBATEN LAW OFFICE
No. 19 2nd flr., Old Market Building,
Upper Magsaysay Ave., Baguio City, 2600