Republic of the Philippines………x)

City of Zamboanga) S.S………….x)

AFFIDAVIT OF LOSS

I, MARITES CALIXTO FONTEJON, of legal age, married, Filipino and

with residence at Baliwasan, Zamboanga City, after being duly sworn to in accordance
with law, depose and say THAT;

1. I am a passbook holder of a Savings Account with Peoples Micro Finance

Cooperative ( PMFC ) Sta. Maria Branch, Zamboanga City with account
number _______________________ issued under my name;

2. The said Savings Account passbook was in my possession since its issuance;

3. Sometime in _______________, the passbook which was in my possession is

missing despite diligent efforts to look for the same and the same is deemed
lost;

4. I am executing this affidavit to attest to the truth of the foregoing narration of

facts, more particularly to declare the loss of my Peoples Micro Finance
Cooperative ( PMFC ) with account No. ______________________, and
in order for me to be issued a new passbook, and for whatever legal purpose
this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on the date and place
hereinafter mentioned.

MARITES CALIXTO FONTEJON

Affiant

SUBSCRIBE AND SWORN to before me this 27 day of September, 2019 at

Zamboanga City, Philippines. Affiant exhibited to me her PhilHealth ID Card No. 14-
050045726-7, known to me and to me known as one and the same person as the Affiant
herein.

Doc. No.____;
Page No.____;
Book No.___;
Series of 2019
Republic of the Philippines………x)
City of Zamboanga) S.S………….x)

AFFIDAVIT OF LOSS

We, MA. VICTORIA CAMINS DAGALEA, of legal age, married, Filipino and JULIAN
VICTOR CAMINS DAGALEA, of legal age, single, Filipino both residence at 517 Acacia St.,
Manggahan, Zamboanga City, after being duly sworn to in accordance with law, depose and say
THAT;

1. I, MA. VICTORIA CAMINS DAGALEA, am a passbook holder of Philippine National

Bank, KCC Branch, Zamboanga City under my name and Philippine National Bank
Passbook, Veterans Branch, Zamboanga City under my name;

2. I, JULIAN VICTOR CAMINS DAGALEA am a passbook holder of Philippine National

Bank, Veterans Branch, Zamboanga City under my name;

3. The said Savings Account passbooks were in the possession of MA. VICTORIA CAMINS
DAGALEA since its issuance and placed the same inside an envelope for safe keeping;

4. Sometime in May, 2018, I MA. VICTORIA CAMINS DAGALEA rode a tricycle brining
along the envelope which contained the said passbooks to do my errands. Upon returning
home, I noticed that the said envelope containing the afore-mentioned passbooks were
missing despite diligent efforts to look for the same and the same are deemed lost;

5. I am executing this affidavit to attest to the truth of the foregoing narration of facts, more
particularly to declare the loss of the PNB Passbooks under the names of MA. VICTORIA
CAMINS DAGALEA and JULIAN VICTOR CAMINS DAGALEA in order for me to
be issued new passbooks, and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on the date and place hereinafter
mentioned.

MA. VICTORIA CAMINS DAGALEA JULIAN VICTOR CAMINS DAGALEA

Affiant Affiant

SUBSCRIBE AND SWORN to before me this 26th day of May, 2018 at Zamboanga
City, Philippines. Affiant exhibited to me her COMELEC Voters registration Card Number
7403-0722A-K2966MCD20000 known to me and to me known as one and the same person
as the Affiant herein.

Doc. No.____;
Page No.____;
Book No.___;
Series of 2018