REPUBLIC OF THE PHILIPPINES )

MEYCAUAYAN, ) SS.

AFFIDAVIT OF LOSS

I, Angela Rez Vixx Cortez, Filipino, of legal age, single, and a resident of #3
Philosophy St. Ph4D Sto. Niño, Meycauayan, Bulacan, after having been duly sworn in
accordance with law, hereby depose and say:

1. That I am a holder of an SSS ID;

2. That I used to put said SSS ID Card together with other personal documents
and identifications in my wallet;

3. That last Wednesday, April 25, 2018, when I was trying to locate my wallet
from where I used to put it unfortunately I could not find it;

4. Despite diligent efforts exerted during the day to find the said wallet including
my SSS ID I could not find it, it is now lost beyond recovery;

5. I am executing this affidavit to attest to the truth of the foregoing and to request
for its replacement and to use it for all intents and legal purposes.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 7th day of

May, 2018 at Meycauayan, Bulacan, Philippines.

___________________________
AFFIANT

Before me a Notary Public for and in Meycauayan, Bulacan, personally appeared

Angela Rez Vixx Cortez on May 7, 2018, who exhibited her TIN ID No. 365245765000.

Notary Public
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Series of 2018.