Republic of the Philippines)

City of Lipa )S.S

AFFIDAVIT OF LOSS

I, ERIC CASTILLO DE CASTRO, of legal age, Filipino and a resident

of Salvador, Agito, Alitagtag, Batangas, after having duly sworn to, in
accordance with law, do hereby depose and state that:

1. I am the lawful owner of an ATM card issued by AUB (Asia

United Bank);

2. I am the lawful holder of a government-issued identification card

bearing the following details:

-ID Type: Unified Multi-Purpose ID

-ID Number: 0111-7735287-1

3. Sometime in August 7, 2023, I was traveling in a public utility

vehicle (jeepney) Lipa-Lemery route;

4. During the course of the journey, while the public utility vehicle
was in motion, an unknown individual made a hole in my sling
bag, which contained my personal wallet, along with other
personal belongings;

5. The wallet contains my ATM Card, UMID, and other personal ID’s
(Voter’s ID);

6. That despite diligent search and efforts to locate said wallet, I

could not find the same such that I now believe that said is now
lost beyond recovery together with the aforesaid ATM Card and
UMID;

7. As such, I am executing this Affidavit of Loss to attest to the truth

of the foregoing and in support of my request / application for the
replacement of the said ATM Card and UMID;
 8. As of this affidavit's preparation, the wallet has not been
recovered, and I believe it to be irretrievable.

IN WITNESS WHEREOF, I hereby set my hand this ___ day of

August in Lipa City, Philippines.

ERIC CASTILLO DE CASTRO

Affiant

  SUBSCRIBED AND SWORN TO before me this ___ day of August in

Lipa City, affiant exhibiting to me his competent evidence of identity by way
of government ID.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of _____.