REPUBLIC OF THE PHILIPPINES)

BACOLOD CITY
)S.S.
AFFIDAVIT OF LOSS
I, NIEL REAGAN BAROY, of legal age, married, and a resident of
Greensville I, Bacolod City, after having been duly sworn on oath in
accordance with law, hereby depose and state that:
1.
I was issued a BIR ID Card with Tax Identification No.
229454014 by the Bureau of Internal Revenue District Office in Cubao
sometime in the year 2003.
2.
I discovered that the above-mentioned original BIR ID Card
was lost and misplaced. Diligent search of said ID card among our
personal effects proved futile and unavailing.
3.
I am executing this affidavit of loss to attest to the truth of
the foregoing and for whatever other legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

on November 25, 2009 at Bacolod City.

NIEL REAGAN BAROY

Affiant
SUBSCRIBED AND SWORN TO before me in Bacolod City this
November 25, 2009. Affiant exhibited to me the following competent
evidence of identity: SSS ID No. 3385597730.
Doc. No._____;
Page No._____;
Book No._____;
Series of 2009.