Republic of the Philippines )

City of Cebu ) S.S.

x--------------------------x

AFFIDAVIT OF DESTRUCTION/MUTILATION OF PASSPORT

I, ACE NORMAN P. ALVERO, of legal age, single, Filipino citizen, and

presently residing at 354-I Betty Lu Compound Queens Road Camputhaw, Cebu City,
with after having been duly sworn to in accordance with law, do hereby depose and say:

1. That I am a holder of Philippine Passport No. 662571

issued on December 16, 2016 by the Department of Foreign
Affairs in Tacloban City, Leyte;

2. That the said passport was damaged/mutilated

because I accidentally dropped it in the toilet due to
excitement;

3. That when I picked it up and tried to dry it, it

already became unreadable;

4. That the damage on the said passport has rendered

it unusable for travel purposes and therefore I request the
Philippine Embassy/ Consulate to issue a replacement
passport in my favor; and,

5. That I attest to the veracity of the foregoing

information.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th day of March
2017 at Cebu City, Philippines.

ACE NORMAN P. ALVERO

Affiant
 SUBSCRIBED AND SWORN to before me this 4th day of March 2017 in
Cebu City, Philippines, affiant exhibiting to me his School ID No. 16101158 and his
Community Tax Certificate No. 63789254 issued on March 1, 2017 at Burauen, Leyte.

JUAN DELA CRUZ

NOTARY PUBLIC
Until December 31, 2018
PTR No. 914762 - Jan. 3, 2020
IBP No. 918920
Roll No. 13377

Doc No. : 3
Page No.: 36
Book No.: 4
Series of 2017