REPUBLIC OF THE PHILIPPINES   )
PROVINCE OF ALBAY             )
CITY OF TABACO                ) S.S
X------------------------------X
                       AFFIDAVIT OF LOSS
I, HANALEE RACIL B. NALLOS, of legal age, Filipino Citizen, married
and with residence address at Block 27, Lot 12, Moran Estate Subd.,
Brgy, Matagbac, Tabaco City, Albay, hereby depose and state that:
     1. I am a holder of non-professional driver’s license no. E08-21-
        002220 issued by Land Transportation Office;
     2. That I usually place the said driver’s license in my pouch
        together with my other cards
     3. yesterday while I was on the SM-Legazpi, I inadvertently put
        my pouch the grocery items I left on the baggage counter;
     4. When I remembered it, I hurriedly went back to the baggage
        counter, however, the said pouch was no nowhere to be found;
     5. I diligently search for it everywhere, however, to date, my
        efforts remain futile. Thus, I have considered it to be lost
        beyond recovery;
     6. That I have executed the foregoing Affidavit to attest the
        truthfulness of the foregoing and for whatever legal intents
        and purposes.
     IN WITNESS WHEREOF, I hereunto set my hand          this   3rd   day   of
February 2025, in Tabaco City, Albay, Philippines.
                       HANALEE RACIL B. NALLOS
                               Affiant
                          UMID CRN 0111-6341995-1
     SUBSCRIBED AND SWORN TO before me in ___________________ this
________________ by the above-named affiant who has satisfactorily
proven her identity through her ID written below his name, known to me
to be the same person who presented and personally signed before me
this document/instrument and attested that the contents thereof are
true and correct; and that she voluntarily executed the same.
                                               NOTARY PUBLIC
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2025