REPUBLIC OF THE PHILIPPINES )
PROVINCE OF BULACAN ) S.S
CITY OF SAN JOSE DEL MONTE)
AFFIDAVIT OF LOSS
I, JOSEFINA B. CASTILLO, of legal age, single, Filipino, and resident
of Sta. Maria, Bulacan after having been duly sworn in accordance with law
depose and say;
1. That, I am the owner of the Professional Identification Card with
Registration No. 0053170;
2. That, sometime on November 2022 I found out that the said ID was
missing and nowhere to be found;
3. That, I exerted diligent efforts to recover the aforementioned ID but
proved futile as the same can no longer be found;
4. That, I am executing this Affidavit of loss to attest to the truth of the
foregoing statements and for all legal intents and purposes it may
serve.
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of
________ 2022 at City of San Jose del Monte, Bulacan.
JOSEFINA B. CASTILLO
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of _____
2022 at City of San Jose del Monte, Bulacan. Affiant exhibited to me her PRC
ID with No. 0053170, SJDM, Bulacan bearing her picture and signature.
Doc No. ___ Notary Public
Page No. ___
Book No. ___
Series of 2022.