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REPUBLIC OF THE PHILIPPINES ) CITY OF DAGUPAN )SS. X-----------------------------------------X AFFIDAVIT OF LOSS I, Tabitha Fortune A.

Francisco, Filipino, of legal age, single and a resident of #2171 Trinidad Subd. Arellano St. Dagupan CIty, Philippines, after having duly sworn to in accordance with law, hereby depose and say that: 1. 2. I am the holder of an Automated Teller Machine number 09194229510 issued by Bank of Philippine Islands; card

I lost said ATM on December 25, 2013 and that I exerted all efforts to locate the same but I could not remember exactly where I placed/left it and it is considered lost for all legal purposes; Said ATM Card was not confiscated by any officer of the law or the officers of the Bank of Philippine Islands by reason of any violation of any law, ordinance, presidential decree or rules and regulation of said bank; and neither was it offered as collateral for any loan; I am executing this affidavit to attest to the foregoing facts;



IN WITNESS WHEREOF, I have hereunto set my hand this 29th of February 2014 in the City of Dagupan, Philippines.
Tabitha Fortune A. Francisco Affiant SUBSCRIBED AND SWORN to before me this 29th day of February 2014 in the City of Dagupan, Philippines, affiant having exhibited to me her community tax certificate with no.989898989889 issued on March 1, 2013 at Dagupan City. Doc. No.____; Page No.____; Book No.____; Series of 2006.

Republic of the Philippines ) Province of Bulacan ) Municipality of Meycauayan) s.s.


We, LEONILO M. GO and MICHAEL S. SY, both Filipinos, of legal ages, married and residents of St. Francis Village, Malhacan, Meycauayan, Philippines, having been duly sworn in accordance with law, hereby depose and state: That we both personally know the person of GLORIA R. LABANDERA since her childhood because formerly, we had lived in the same locality for a long time, and her family has been a close family friend; That we also know and we hereby declare that the said GLORIA R. LABANDERA was born on May 24, 1980 at Meycauayan, Bulacan, Philippines to PERLA R. LABANDERA and ARIEL LABANDERA; That we are not related in any way, either by consanguinity or affinity, to the said GLORIA R. LABANDERA; As such, we execute this Joint Affidavit to attest to the truth of the foregoing facts and for any other legal purpose that this Affidavit may serve. IN WITNESS WHEREOF, we have hereunto set our hands this 1st day of August 2013, at Meycauayan, Bulacan, Philippines. LEONILO M. GO SY t Affiant MICHAEL S. Affian

SUBSCRIBED AND SWORN TO before me this 1st day of August 2013 in Meycauayan, Bulacan, affiants exhibited to me their SSS Identification Card Nos. 1234 and 4567 issued on March 6, 2012 and April 8, 2012, respectively, in Makati City, Metro Manila. Doc. No. _____ Page No. _____ Book No. _____ Series of 2013.