Republic of the Philippines)

City of Cebu) S.S.

AFFIDAVIT OF DESTRUCTION/MUTILATION

I, MS. VARLDEN GHIA BRAZA FUERZAS, of legal age, Filipino, single, and
resident of Block 7, Lot 7, Mimosa, Labangon, Cebu City 6000, Cebu, after being duly
sworn according to law, hereby depose and state that:

1. I am the owner and holder of a Philippine Passport ID with Passport No.

EC1901452, issued on August 14, 2014, by the Department of Foreign Affairs.
2. Sometime on May 12, 2023, while traveling from Ozamis to Cebu, some of my
personal belongings, specifically a compact wallet where I put most of my
government-issued, identification cards, was drenched with rain water due to
heavy rain at that time. Along with those that were drenched with rain was
my Passport ID.
3. That the damage on the said passport has rendered it unusable for travel
purposes and therefore I request the Department of Foreign Affairs to reissue
a new Philippine Passport in my favor as replacement; and,
4. I am executing this Affidavit to attest to the truth of the foregoing statements.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this October 16, 2023, at Room
2-3, 3rd Floor, Albulario Building, Barangay Kamputhaw, Cebu City 6000, Cebu,
Philippines.

VARLDEN GHIA BRAZA FUERZAS

Affiant

SUBSCRIBED AND SWORN to before me this 16th day of October 2023, at 3F

Albulario Building, General Maxilom Avenue, Barangay Kamputhaw, Cebu City 6000,
Cebu, Philippines. Further, I certify that I personally know the said affiant, have
personally examined her, and that she voluntarily executed and fully understood her
statements.

NOTARY PUBLIC

Page 1 of 1
Affidavit of Ms. Varlden Ghia B. Fuerzas