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AFFIDAVIT OF LOSS
1. I am a SENIOR CITIZEN;
2. By virtue of my SENIOR CITIZEN, I was issued an Identification Card;
3. Said Identification Card was lost sometime on ____________________
at home, Mercedes, Zamboanga City;
4. Hereunder are the facts and circumstances surrounding the loss of my
Identification Card:
That I always place my Senior Identification Card with bearning No.
_________________, at my personal Cabinet and when I check the said
Senior Citizen Identification card I was surprised that it was lost at my
cabinet that due to effort exerted to locate the same is not found and
beyond recovery;
5. I made diligent search to recover the said Identification Card but proved
futile;
6. For all legal intents and purposes the said Senior Citizen Identification
Card is now considered lost and beyond recovery;
7. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose/s it may serve.
FAUSTINA F. ISIDRO
Affiant
NOTARY PUBLIC