REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, ANGELO VILLANUEVA ALICAYCAY, of legal age, Filipino, single and
with residence at San Antonio, Gerona Tarlac, after having been duly sworn to
in accordance with law hereby depose and state that:
1. I am a holder of a Postal Identification Card, which I usually keep inside
my wallet;
2. That sometime on July 2019, when I was organizing the contents of my
wallet, I discovered that my Postal I.D. was missing. I tried to look for it
in my other wallets but I did not find the same.
3. That despite diligent search and efforts to locate the said identification
card including the above said identification card but I could not find the
same such that I believe that it is now lost beyond recovery;
4. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 2 nd day of
January 2020 in the Province of Tarlac, Philippines.
ANGELO VILLANUEVA ALICAYCAY
Affiant
SUBSCRIBED AND SWORN TO before me this 2nd day of January 2020
in the Province of Tarlac, Philippines, affiant exhibited to me his TIN I.D. with
number 749-808-112-000.
ATTY. JENY ANNE D. MADAMBA
Notary Public until December 31, 2020
Carriedo St. Paniqui, Tarlac 2307
Roll No. 69184/May 31, 2017
PTR No. 0114859; January 02, 2020; Paniqui, Tarlac
IBP No. 017673; July 15, 2017; Tarlac Chapter
MCLE Compliance No. VI-0011044
REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, MICHELLE ERIN KATE V. CORTEZ, of legal age, Filipino and with
residence at Paniqui, Tarlac, after having been duly sworn to in accordance
with law hereby depose and state that:
1. I am a registered pharmacist and was issued an PRC I.D. with
Registration No. 0077618 issued by the Professional Regulation
Commission of Manila;
2. I usually keep the said PRC I.D. and other identification cards inside my
wallet;
3. That sometime on July 2019, when I was organizing the contents of my
wallet, I discovered that my PRC I.D was missing. I tried to look for it in
my other wallets but I did not find the same.
4. That despite diligent search and efforts to locate the said identification
card I could not find the same such that I believe that it is now lost
beyond recovery;
5. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of
August 2019 in the Province of Tarlac, Philippines.
MICHELLE ERIN KATE V. CORTEZ
Affiant
SUBSCRIBED AND SWORN TO before me this 15th day of August 2019
in the Province of Tarlac, Philippines.
Doc. No. ___;
Page No. ___;
Book No. ___;
Series of 2019.
REPUBLIC OF THE PHILIPPINES }
MUNICIPALITY OF PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, SAMUEL DASCO MANUEL, of legal age, Filipino, married and with
residence at Carbonel Gerona, Tarlac, after having been duly sworn to in
accordance with law hereby depose and state that:
1. I am a registered teacher and was issued an PRC identification card with
Registration No. 1080710, which is valid until April 12, 2022 and was
issued by the Professional Regulation Commission of Manila;
2. I usually keep the said PRC I.D. and other identification cards inside my
wallet;
3. That sometime on November 18, 2019, when I was organizing the
contents of my wallet, I discovered that my PRC I.D was missing. I tried
to look for it in my other wallets but I did not find the same.
4. That despite diligent search and efforts to locate the said identification
card I could not find the same such that I believe that it is now lost
beyond recovery;
5. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of
December 2019 in the Province of Tarlac, Philippines.
SAMUEL DASCO MANUEL
Affiant
SUBSCRIBED AND SWORN TO before me this 17th day of December
2019 in the Province of Tarlac, Philippines, affiant exhibited to me his UMID
I.D. with number CRN-021-1366-1955-5.
Doc. No. ___;
Page No. ___;
Book No. ___;
Series of 2019.
REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, ANGELO VILLANUEVA ALICAYCAY, of legal age, Filipino, single and
with residence at San Antonio, Gerona Tarlac, after having been duly sworn to
in accordance with law hereby depose and state that:
5. I am a holder of a Postal Identification Card, which I usually keep inside
my wallet;
6. That sometime on July 2019, when I was organizing the contents of my
wallet, I discovered that my Postal I.D. was missing. I tried to look for it
in my other wallets but I did not find the same.
7. That despite diligent search and efforts to locate the said identification
card including the above said identification card but I could not find the
same such that I believe that it is now lost beyond recovery;
8. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 2 nd day of
January 2020 in the Province of Tarlac, Philippines.
ANGELO VILLANUEVA ALICAYCAY
Affiant
SUBSCRIBED AND SWORN TO before me this 2nd day of January 2020
in the Province of Tarlac, Philippines, affiant exhibited to me his TIN I.D. with
number 749-808-112-000.
ATTY. JENY ANNE D. MADAMBA
Notary Public until December 31, 2020
Carriedo St. Paniqui, Tarlac 2307
Roll No. 69184/May 31, 2017
PTR No. 0114859; January 02, 2020; Paniqui, Tarlac
IBP No. 017673; July 15, 2017; Tarlac Chapter
MCLE Compliance No. VI-0011044
REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, MICHELLE ERIN KATE V. CORTEZ, of legal age, Filipino and with
residence at Paniqui, Tarlac, after having been duly sworn to in accordance
with law hereby depose and state that:
6. I am a registered pharmacist and was issued an PRC I.D. with
Registration No. 0077618 issued by the Professional Regulation
Commission of Manila;
7. I usually keep the said PRC I.D. and other identification cards inside my
wallet;
8. That sometime on July 2019, when I was organizing the contents of my
wallet, I discovered that my PRC I.D was missing. I tried to look for it in
my other wallets but I did not find the same.
9. That despite diligent search and efforts to locate the said identification
card I could not find the same such that I believe that it is now lost
beyond recovery;
10. That as such, I am executing this affidavit to attest to the foregoing
facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of
August 2019 in the Province of Tarlac, Philippines.
MICHELLE ERIN KATE V. CORTEZ
Affiant
SUBSCRIBED AND SWORN TO before me this 15th day of August 2019
in the Province of Tarlac, Philippines.
Doc. No. ___;
Page No. ___;
Book No. ___;
Series of 2019.
REPUBLIC OF THE PHILIPPINES }
MUNICIPALITY OF PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, CHRISTIAN RAY NEBRE VIRAY, of legal age, Filipino, married and
with residence at Brgy. Pinasling, Gerona, Tarlac, after having been duly sworn
to in accordance with law hereby depose and state that:
1. I am a holder of Persons With Disabilities (PWD) identification card;
2. I usually keep the said PWD I.D. and other identification cards inside my
wallet;
3. That sometime on Febrauary 02, 2020, when I was organizing the
contents of my wallet, I discovered that my PWD I.D. was missing. I tried
to look for it in my other wallets but I did not find the same.
4. That despite diligent search and efforts to locate the said identification
card I could not find the same such that I believe that it is now lost
beyond recovery;
5. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day of
February 2020 in the Province of Tarlac, Philippines.
CHRISTIAN RAY NEBRE VIRAY
Affiant
SUBSCRIBED AND SWORN TO before me this 5th day of February 2020
in the Province of Tarlac, Philippines, affiant exhibited to me his Driver’s
License with number C11-02-157111.
Doc. No. ___;
Page No. ___;
Book No. ___;
Series of 2020.
REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, TERESA VILLANUEVA LABAYOG, of legal age, Filipino, married and
with residence at Purok 7, Mabilang, Paniqui Tarlac, after having been duly
sworn to in accordance with law hereby depose and state that:
1. I am a holder of Social Security System (SSS) identification card duly
issued by SSS Cavite, which I usually keep inside my wallet;
2. That sometime on December 30, 2019, when I was organizing the
contents of my wallet, I discovered that my SSS I.D. was missing. I tried
to look for it in my other wallets but I did not find the same.
3. That despite diligent search and efforts to locate the said identification
card including the above said identification card but I could not find the
same such that I believe that it is now lost beyond recovery;
4. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 14 th day of
February 2020 in the Province of Tarlac, Philippines.
TERESA VILLANUEVA LABAYOG
Affiant
SUBSCRIBED AND SWORN TO before me this 14th day of February 2020
in the Province of Tarlac, Philippines, affiant exhibited to me her voter’s
identification card with number VIN: 6910-0162A-F1773TVL20000.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2020.
REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSSP
I, JEFFREY GRANDE DUGAY, of legal age, Filipino, married and with
residence at Nancamarinan, Paniqui, Tarlac after having been duly sworn to in
accordance with law hereby depose and state that:
1. I am a holder of company identification card duly issued by Luen Thai
International located at Andres Bonifacio Avenue, Clark Freeport,
Mabalacat, Pampang, which I usually keep inside my wallet;
2. That sometime on March 8, 2020 when I was organizing the contents of
my wallet, I discovered that my company identification card was missing.
I tried to look for it in my other wallets but I did not find the same.
3. That despite diligent search and efforts to locate the said identification
card including the above said identification card but I could not find the
same such that I believe that it is now lost beyond recovery;
4. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 9 th day of
March 2020 in the Province of Tarlac, Philippines.
JEFFREY GRANDE DUGAY
Affiant
SUBSCRIBED AND SWORN TO before me this 9th day of March 2020 in
the Province of Tarlac, Philippines.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2020.
REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF DISCLOSURE
I, ________________________, of legal age, Filipino, married and with
residence at Paniqui Tarlac, after having been duly sworn to in accordance with
law hereby depose and state that:
1. That I am not in anyhow related or affiliated with any of the appointing
or recommending authority or officers of the Department of Environment
and National Resources;
2. That at the present there is NO existing conflict of interest with my
application for employment with the Department of Environment and
National Resources;
3. That as such, I am executing this affidavit to attest to the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of
June 2020 in the Province of Tarlac, Philippines.
____________________________
Affiant
SUBSCRIBED AND SWORN TO before me this 29th day of June 2020 in
the Province of Tarlac, Philippines, affiant exhibited to me her voter’s id with
number VIN: ____________________________.
