Republic of the Philippines)

City of Cagayan de Oro

) S.S.
AFFIDAVIT OF LOSS

I, SUNG EGIEJIE A. FABRE, Filipino, 35 years old, married, and a resident of

Cogon, Balingasag, Misamis Oriental, after having been sworn to an oath in accordance
with law, do hereby depose and say:
1. That I am the lawful owner / holder of the Identification Data Card duly issued by
the Philippine Drug Enforcement Agency on;
2. That the above-mentioned Identification Data Card was in my possession until I
discovered that the same is missing;
3. That diligent and earnest efforts to locate the same proved futile and the said
Identification Data Card is now lost and beyond recovery;
4. That I am executing this affidavit to attest to the truth of the foregoing, for
whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 22nd day of April
2016 in Cagayan de Oro City, Philippines.

SUNG EGIEJIE A. FABRE

Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of April 2016 in Cagayan
de Oro City, Philippines.

Notary Public