REPUBLIC OF THE PHILIPPINES )

CALAMBA CITY )S.S.

AFFIDAVIT OF LOSS

I, MARGARITA LOZANO BULAN, Filipino, of legal age,

single, presently residing and with postal address at Brgy. San
Jose, Calamba City, after oath depose and state:

THAT, I am an employee of MONDE MISSIN

CORPORATION, with business address at Brgy. Balibago, Santa
Rosa City since 1992;

THAT, as such, I was issued an EMPLOYEE

IDENTIFICATION CARD NO. 931504;

THAT, said ID was discovered missing on or about 10

O’clock night time of January 15, 2011, after reaching our house
from the office;

THAT, I exerted my best efforts to locate said ID, but

proved futile, hence said ID is considered lost forever;

THAT, I am executing this affidavit to attest to the

truthfulness of the above facts and to request the management of
MOONDE NISSIN to issue a replacement ID with the same
force and effect as the lost one.

MARGARITA LOZANO BULAN

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this 19 th day

of January 2011 at Calamba City, affiant exhibited her
COMELEC VOTER ID PRECINT NO. 0647A and SOCIAL
SECURITY ID NO. 04-0628671-6, with her picture and signature
appearing therein to prove her identity.
REPUBLIC OF THE PHILIPPINES )
CALAMBA CITY, LAGUNA }S.S.

JOINT AFFIDAVIT OF DISCREPANCY

WE, ANTONIO C. YEE and CHARLITO MAMORNO, both Filipino, of

legal ages and presently residing at Adelina Village, Brgy. Pulo, Cabuyao,
Laguna,,, sworn in accordance with law, depose and say:

THAT we personally know VICENTE NOVA ANARNA, born last April 5, 1957 with
parents Felipe Anarna and Irenea Nova;;

THAT in his school records, all Ids Certificate of Live Birth and record at
the company he used to work, his birthday is recorded April 5, 1958;

THAT with this affidavit, we attest that Vicente N. Anarna born last April
5, 1957 aqnd Vicente N. Anarna born last April 5, 1958 is one and the same
person.

THAT we know all these facts because we are his longtime friends and
neighbors.

THAT we are executing this affidavit to attest the truthfulness of the

above facts and for whatever lawful purpose it may serve.;

.
AFFIANTS FURTHER SAYETH NAUGHT.

ANTONIO YEE CHARITO MAMORNO

Affiant affiant

SUBSCRIBED AD SWORN to brfore me this 29 th day of March, 2010,

exhibiting their CTC Nos. and issued at
and on and

.
 ATTY. GREGORIO E. MAUNAHAN
Notary Public
Until December 31, 2009
PTR NO. 4177872/1-05-09/ Calamba City, Laguna
IBP LIFE MEMBER Roll No. 1404 OR 458740 Pasig City
TIN- 215-321-2089/MCLE ComplianceIII-0705

Doc No. 7015

Page No. 515;
Book No. XII;
Series of 2009.

REPUBLIC OF THE PHILIPPINES)

CALAMBA CITY, LAGUNA }S.S.

JOINT AFFIDAVIT OF IDENTITY

WE, CORAZON MALABAG and BUENAVENTURA OLVINA, both Filipino

Citizen, of legal age, and presently residing at Rizal Street and Barangay Tulo,
Calamba City, after having sworn in accordance with law, depose and say:

THAT we personally know PAULINO JUAN CAMATA of Barangay San Juan,

Calamba City, Laguna since birth;

THAT we have personal knowledge that sometimes Paulino Juan Camata uses
only PAULINO in some of his business and official transaction;

THAT we have personal knowledge and it is publicly known in the community

that PAULINO JUAN CAMATA is one and the same PAULINO CAMATA;

THAT this affidavit is being executed to attest to the fact that PAULINO JUAN
CAMATA and PAULINO CAMATA is one and the same person and to support the
claims of his legal heirs for BURIAL CLAIM from the SSS;
 IN WITNESS WHEREOF, we have hereunto affixed our signatures this 28 th day
of June, 2001 in the city of Calamba, province of Laguna.

CORAZON MALABAG BUENAVENTURA OLVINA

Affiant Affiant

SUBSCRIBED AND SWORN to before me this 28th day of June 2001,

Affiant exhibiting to me their Community Tax No. 12190485 issued at Calamba City,
Laguna on March 30, 2001. . .

ATTY. GREGORIO E. MAUNAHAN

Notary Public
Until December 31, 2001
PTR NO. 4885838;1-2-2001 Calamba, Laguna
IBP LIFEMEMBER Roll No. 1404 Pasig City
Doc No. 369
Page No. 12
Book No. VI
Series of 2001

REPUBLIC OF THE PHILIPPINES)

CALAMBA CITY, LAGUNA }S.S.

JOINT AFFIDAVIT OF IDENTITY

WE, CORAZON MALABAG and BUENAVENTURA OLVINA, both Filipino

Citizen, of legal age, and presently residing at Rizal Street and Barangay Tulo,
Calamba City, after having sworn in accordance with law, depose and say:

THAT we personally know ROBERTO REMBON of Barangay Real , Calamba

City, Laguna since birth;

THAT we have personal knowledge that sometimes Roberto uses only Robert
in some of his business and official transaction;

THAT we have personal knowledge and it is publicly known in the community

that ROBERTO REMBON is one and the same ROBERT REMBON;

THAT this affidavit is being executed to attest to the fact that ROBERTO
REMBON and ROBERT REMBON is one and the same person and to support the
claims of his legal heirs for SURVIVORSHIP AND BURIAL CLAIM from the GSIS;
 IN WITNESS WHEREOF, we have hereunto affixed our signatures this 28 th day
of June, 2001 in the city of Calamba, province of Laguna.

CORAZON MALABAG BUENAVENTURA OLVINA

Affiant Affiant

SUBSCRIBED AND SWORN to before me this 28th day of June 2001,

Affiant exhibiting to me their Community Tax No. 12190485 issued at Calamba City,
Laguna on March 30, 2001. . .

ATTY. GREGORIO E. MAUNAHAN

Notary Public
Until December 31, 2001
PTR NO. 4885838;1-2-2001 Calamba, Laguna
IBP LIFEMEMBER Roll No. 1404 Pasig City
Doc No. 370
Page No. 12
Book No. VI
Series of 2001