Republic of the Philippines )

Province of Cagayan ) S.S.

City of Tuguegarao )
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AFFIDAVIT OF LOSS

I, OWEN PAUL P. CAGURANGAN, of legal age, married, Filipino citizen, and a

resident of Poblacion 1, Piat, Cagayan, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state, THAT –

1) I own a wallet containing some cash, my Professional Regulatory Commission (for

registered nurses) identification card, nursing license (Saudi Arabia) and other
personal belongings;

2) On October 10, 2023, after reaching home, I discovered that my wallet, which I
earlier placed inside my shoulder bag, was missing;

3) Immediately, I thoroughly search the contents of my bag hoping that my wallet was
mixed with my other personal belongings but I found nothing;

4) All efforts exerted to locate the said wallet including the said cash, my Professional
Regulatory Commission (for registered nurses) identification card, nursing license
(Saudi Arabia) and other personal belongings, but the same proved futile. Thus, I now
consider them as lost and beyond recovery;

5) The said ID cards were never pledged or used as a security to any obligations;

6) I am executing this affidavit to attest to the truth of the foregoing statements and for
whatever legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this October 20, 2023 at
Tuguegarao City, Cagayan, Philippines.

OWEN PAUL P. CAGURANGAN

Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicated above.
Affiant exhibited before me his Philippine Passport with Number P9102099B issued by the
Department of Foreign Affairs, Tuguegarao City, which is valid until 29 February 2032.

Doc. No. ________ ATTY. KEITHLEY DON P. PAGUIRIGAN

Page No. ________ Notary Public – Province of Cagayan
Book No. ________ Attorney’s Roll No. 83341
Series of 2023. Commission No. RTC-TUG-2022-36
Until December 31, 2023
IBP O.R. No. 265422/ 03 January 2023/ Cagayan Chapter
PTR O.R. No. 12773415/Tug. City/05 January 2023
2/F Josefina R. Abraham Center, Bonifaco Street corner
Aguinaldo Street, Centro 06, Tug. City 3500 Cagayan