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REPUBLIC OF THE PHILIPPINES)

CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, MILA M. DELA PEA, of legal age, Filipino, married and a resident


of Doa Feliza Mejia, Ormoc City, after having been duly sworn to in
accordance with law, hereby depose and say:

That I am a P.O. Guarantor of Gaisano Capital, Credit Department in


Ormoc City, Leyte under P.O. Guarantor No. 09070601181;

That sometime last month I received two (2) pcs. P.O. Cards bearing
card nos. 1189899 and 1189900;

That said P.O. cards, however, could no longer be found and were
believed to have been irretrievably lost;

That earnest efforts were exerted to locate said P.O. cards but to no
avail and same can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the above


facts and for whatever legal purpose this may serve best in the
premises.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day


of September, 2015 at Ormoc City, Philippines.

MILA M. DELA PEA


Affiant

SUBSCRIBED AND SWORN to before me this _____ day of September


2015 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
In the City of Ormoc . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, JESSICA T. ABET, of legal age, Filipino, maried and a resident of


Villa Theresa subdivision, Brgy. San Isidro, Ormoc City, Leyte, after having
been duly sworn to in accordance with law, hereby depose and say:

That I am a the mother of Samanta T. Abit, a Fourth Year student of


New Ormoc City National High School, Ormoc City, this school year
2014-2015;

That my daughter, SAMANTA T. TABIT was issued a HEALTH and P.E.


Original book from said school and was lost last February 2015;

That however, the said original book was lost and despite the diligent
efforts that I have exerted to find it, the same could and is probably
lost for all intents;

That I am executing this affidavit to established the truth to the


foregoing statement for the loss of the original copy of the said book
and for whatever purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___th day


of June, 2015 at Ormoc City, Philippines.

JESSICA T. ABIT
Affiant

SUBSCRIBED AND SWORN to before me this _____th day of June


2015 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, GLENN P. VERGARA, of legal age, Filipino, married and a


resident of Sitio Coob, Brgy. Tambulilid, Ormoc City, Leyte, after
having been duly sworn to in accordance with law, hereby depose and
say:

That I am a holder of a Student Permit issued by the Land


Transportation Office, Ormoc City ;

That recently, I discovered that said O.R was no longer in my


possession. Same may have been lost or was misplaced
somewhere and could no longer be found;

That earnest efforts were exerted to locate said Student Permit


but to no avail and can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 15th


day of November, 2016 at Ormoc City, Philippines.

GLENN P. VERGARA
Affiant

SUBSCRIBED AND SWORN to before me this 15th day of


November 2016 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, LEA ANGELIQUE MONTEHERMOSO PEREZ, of legal age,


Filipino, single and a resident of 180 London St., Doa Feliza Z. Mejia,
Ormoc City, Leyte, after having been duly sworn to in accordance with
law, hereby depose and say:

That I am a holder of a Student Permit with O.R. No.


000201463643191 issued by the Land Transportation Office,
Ormoc City ;

That recently, I discovered that said O.R was no longer in my


possession. Same may have been lost or was misplaced
somewhere and could no longer be found;

That earnest efforts were exerted to locate said O.R but to no


avail and can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 15th


day of February, 2016 at Ormoc City, Philippines.

LEA ANGELIQUE M. PEREZ


Affiant

SUBSCRIBED AND SWORN to before me this 15th day of


February 2016 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, KENT EMMANUEL T. ABIT, of legal age, Filipino, single and


a resident of Villa Theresa subdivision, Ormoc City, Leyte, after having
been duly sworn to in accordance with law, hereby depose and say:

That I am a holder of a Non-Professional Drivers License O.R


No. issued by the Land Transportation Office, Ormoc City ;

That recently, I discovered that said Non-Professional Drivers


License was no longer in my possession. Same may have been
lost or was misplaced somewhere and could no longer be found;

That earnest efforts were exerted to locate said Non-Professional


Drivers License but to no avail and can be considered as forever
lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 19th


day of January, 2017 at Ormoc City, Philippines.

KENT EMMANUEL T. ABIT


Affiant

SUBSCRIBED AND SWORN to before me this 19th day of


January 2017 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, NELSON B. BINUEZA, of legal age, Filipino, married and a


resident of Brgy. Curva, Ormoc City, Leyte, after having been duly
sworn to in accordance with law, hereby depose and say:

That I am a the registered owner of a Yamaha Motorcycle with


Plate no. 9857HD;

That I recently discovered that the Plate Card of my motorcycle


was no longer attached to my motorcycle. The same might have
been stolen while it was parked at Western Training, Bonifacio
St., Ormoc City;

That I have exerted earnest efforts to locate the said Plate Card
but to no avail and might be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this ___th


day of June, 2016 at Ormoc City, Philippines.

NELSON B. BINUEZA
Affiant

SUBSCRIBED AND SWORN to before me this ___th day of June


2015 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, EMMANUEL T. ABIT, of legal age, Filipino, single and a resident of


Villa Theresa Subdivision, Brgy. San Isidro, Ormoc City, Leyte, after having
been duly sworn to in accordance with law, hereby depose and say:

That I am a holder of a PRC ECARD issued by GSIS Ormoc


Branch;

That recently, I discovered that said ECARD was no longer in my


possession. Same may have been lost or was misplaced
somewhere and could no longer be found;

That earnest efforts were exerted to locate said ECARD but to no


avail and can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th


day of August, 2015 at Ormoc City, Philippines.

ZOILO P. PULIDO
Affiant

SUBSCRIBED AND SWORN to before me this 18th day of August


2015 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, ZOILO P. PULIDO, of legal age, Filipino, single and a


resident of Purok 1, Looc Linao, Ormoc City, Leyte, after having been
duly sworn to in accordance with law, hereby depose and say:

That I am a holder of a PRC ECARD issued by GSIS Ormoc


Branch;

That recently, I discovered that said ECARD was no longer in my


possession. Same may have been lost or was misplaced
somewhere and could no longer be found;

That earnest efforts were exerted to locate said ECARD but to no


avail and can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th


day of August, 2015 at Ormoc City, Philippines.

ZOILO P. PULIDO
Affiant

SUBSCRIBED AND SWORN to before me this 18th day of August


2015 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, MARIA CARMELITA O. PORE, of legal age, Filipino, single and


a resident of Pacific Bay Villas, Brgy. San Pablo, Ormoc City, Leyte,
after having been duly sworn to in accordance with law, hereby depose
and say:

That I am a holder of a Robinsons Rewards Plus Card issued by


Robinsons, Ormoc Branch;

That recently, I discovered that said CARD was no longer in my


possession. Same may have been lost or was misplaced
somewhere and could no longer be found;

That earnest efforts were exerted to locate said CARD but to no


avail and can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the


above facts and for whatever legal purpose this may serve best
in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 28th


day of July, 2016 at Ormoc City, Philippines.

MARIA CARMELITA O. PORE


Affiant

SUBSCRIBED AND SWORN to before me this 28th day of July


2016 at Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, ELMER A. NAPOLES, of legal age, Filipino, married and a resident of


Puntaville, Brgy. Tambulilid, Ormoc City, Leyte, after having been duly sworn to in
accordance with law, hereby depose and say:

That I am a subscriber of a Smart Bro internet service under Account No. 101-
1132014;

That along with its contract package, an antenna was installed to effect its internet
service;

That said antenna, however, was lost and or completely destroyed by the strong
winds caused by super typhoon Yolanda that hit the provinces of Leyte and
Samar last November 8, 2013;

That earnest efforts were exerted to locate said antenna but to no avail and same
can be considered as forever lost;

That I am executing this affidavit to attest to the veracity of the above facts and
for whatever legal purpose this may serve best in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 25th day of March,
2014 at Ormoc City, Philippines.

ELMER A. NAPOLES
Affiant

SUBSCRIBED AND SWORN to before me this 25th day of March 2014 at


Ormoc City, Philippines.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT

I, JOREYVEN R. ORTIZ, of legal age, Filipino, and a residing at Philrads,


Tambulilid, Ormoc City after having been duly sworn to accordance with law, hereby
depose and say:

1. That I am reporting to Bureau of Internal Revenue (BIR) a certain Gregorio


Calvo engaged in welding shop business has no registration with the BIR
since the business was opened. The said business is located at Philrads,
Tambulilid, Ormoc City.
2. That this affidavit is being executed of my free will and without anticipating
any reward or consideration whatever.

JOREYVEN R. ORTIZ
Affiant

SUBSCRIBED AND SWORN to before this _______________ day of _____________


20_____, in _______________________, affiant exhibiting to me his/her residence
at________________________________.
REPUBLIC OF THE PHILIPPINES)
CITY OF ORMOC . . . . . . . . . . . . . ) S.S

AFFIDAVIT OF LOSS

I, JEMMAR J. DE ASIS, of legal age, Filipino, single and a resident of Brgy.


Nasunogan, Ormoc City, after having been duly sworn to in accordance with law,
hereby depose and say THAT :

I am a holder of ATM Card No. 8007200288463 and Savings No.


501562200000660, City Savings Bank, Ormoc Branch;

I discovered that said ATM Card was no longer in my possession, which may
have been lost or misplaced and could no longer be found;

Earnest efforts were exerted to locate said ATM but to no avail and can be
considered as forever lost;

That I am executing this affidavit to attest to the veracity of the above facts
for whatever legal purpose this may serve best in the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this 22 nd day of


September, 2015 at Ormoc City, Philippines.

JEMMAR J. DE ASIS
Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of September 2015 at


Ormoc City, Philippines.

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