REPUBLIC OF THE PHILIPPINES)
MUNICIPALITY OF IBA          ) S.S.
PROVINCE OF ZAMBALES         )
                       AFFIDAVIT OF LOSS
      I, SWANIE D. ABION, Filipino, of legal age, Married, and with
residence and postal address at Zone 2, Iba, Zambales, being first duly
sworn in accordance with law, depose and state that:
      1. I am a Social Security System ID holder with ID No:02-
         1215552-3;
      2. However, last 2005, I noticed that my SSS ID was missing
         from my wallet when I checked my belongings;
      3. I searched high and low for my SSS ID but still could not
         locate the same;
      4. I hereby expressly state that the aforementioned SSS ID can
         now be considered, for all legal intents and purposes, lost
         beyond recovery; and
      5. I am executing this affidavit to attest to the truth and veracity
         of the foregoing facts.
                                                    SWANIE D. ABION
                                                          Affiant
      SUBSCRIBED AND SWORN to before me this ________________ at
Iba, Zambales. Affiant exhibited to me her GSIS Id No.: 02004029990.
Doc. No.    _____;
Page No.    _____;
Book No. _____;
Series of 2017.