Republic of the Philippines )

City of Tacloban ) S.S.

AFFIDAVIT OF LOSS
I, LAARNI PEDERE DE LA CRUZ, of legal age, married, Filipino,
and residing at B15 L22, Kristina Heights Subdivision, Tacloban City,
hereby depose and state: THAT---

1. I was a holder of PRC ID issued by Philippine Regulation

Commission (PRC) being a Registered Nurse;

2. While I was traveling to downtown Tacloban City last 17 April

2018, my wallet got lost which included the said PRC ID issued by PRC;

3. Despite diligent search and efforts to locate the said wallet

which contains my PRC ID I could not find the same such that I now
believe that it is now lost beyond recovery;

4. I am executing this affidavit to attest to the truth of the loss of

said PRC ID so that I will be issued a new one by PRC and for whatever
legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 22 May

2018 at Tacloban City.

LAARNI PEDERE DE LA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me on this 22 May 2018 at

Tacloban City, affiant is personally known to me and known to me as the
same person who personally signed before me the foregoing affidavit and
acknowledged that she executed the same.

Doc. No. 70
ATTY. NILE APRIL PELLERO ROBIÑO
Page No. 15 Notary Public for Tacloban City and Province of Leyte
Notarial Commission No. NC-2018-1-07 until December 31, 2019
Book No. III Roll of Attorney’s No. 65007
SERIES OF 2018 IBP Lifetime No. 017601; 06-07-17; Leyte Chapter
PTR No. 1077452; 01-04-18; Julita, Leyte
2F Wenzhuan Bldg., Abucay Terminal Road, Tacloban City