REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I, GILDA JOVEN PILLARDA, of legal age, Filipino and with address at 332
Avocado St., Real 2, Justineville Subd., Bacoor, Cavite, after having been duly sworn
to in accordance with law, hereby depose and say that:
1. I am a holder and owner of SSS identification card no.
issued by the Social Security System (SSS).

03-9039189-8

2. On or January 2014, my said SSS identification card was lost.

3. Despite of diligent efforts to look for my said identification card, all such
efforts proved futile and in vain, thus, I am declaring the loss of my said SSS
identification card.
4. I have never lent or allowed any person to use my said SSS identification
card, nor has such SSS id card been confiscated by law enforcement agencies or
the subject of any pending litigation.
5. I am executing this affidavit to attest to the truth of the foregoing facts for
all its legal intents, effects, consequences and purposes including for the issuance
to me of another SSS identification card in lieu of the one that was lost.

GILDA JOVEN PILLARDA

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this July 28, 2014 at Las
Pinas City.

Doc No. 183

Page No. 37
Book No. 85
Series of 2014

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY
)S.S.

AFFIDAVIT OF LOSS
I, JOCELYN ROMA TORRES, of legal age, Filipino and with address at #10
Kalantas St., Brgy. Western, Taguig City, after having been duly sworn to in
accordance with law, hereby depose and say that:
1. I am a holder and owner of SSS identification card no. 06-2640506-3
issued by the Social Security System (SSS).
2. My said SSS identification card was lost.
3. Despite of diligent efforts to look for my said identification card, all such
efforts proved futile and in vain, thus, I am declaring the loss of my said SSS
identification card.
4. I have never lent or allowed any person to use my said SSS identification
card, nor has such SSS id card been confiscated by law enforcement agencies or
the subject of any pending litigation.
5. I am executing this affidavit to attest to the truth of the foregoing facts for
all its legal intents, effects, consequences and purposes including for the issuance
to me of another SSS identification card in lieu of the one that was lost.

JOCELYN ROMA TORRES

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this July 2, 2014 at Las Pinas
City.

Doc No. 159

Page No. 33
Book No. 84
Series of 2014