Republic of the Philippines
Province of Cebu
S.S
City of Cebu
X---------------------------x
AFFIDAVIT OF LOSS
I, Daryl C. Abocot, of legal age, Filipino, single and with residence at G7 Residence Hall, Brgy.
Kamagayan, Junquera St., Cebu City, Cebu, after having been duly sworn to in accordance with law, hereby
depose and state:
1. That I am a holder of a BPI ATM with account number 9209069722 duly issued by Bank of
the Philippine Islands, P. Del Rosario Branch in Cebu City;
2. That sometime on June 5, 2019, when I arrived home from work, I discovered that said
ATM card was no longer in my wallet where I used to place it;
3. That despite diligent search and effort to locate my ATM card, I could not find it and such
it proved futile and lost beyond recovery;
4. That in view thereof, I am now executing this affidavit to attest to the truth of the
foregoing facts and hereby request BPI to issue another ATM card in lieu of the lost one.
IN WITNESS WHEREOF, I have hereunto set my hand this 21th day of June 2019 in Cebu City,
Cebu, Philippines.
DARYL C. ABOCOT
Affiant
Subscribed and sworn to before me this ___ day of June 2019 at Cebu City, Cebu. Affiant exhibiting
to me his _________________________________________________________________ as competent
proof of his identity.
Doc. No. _______:
Page No. _______:
Book No. _______:
Series of 2019