AFFIDAVIT OF LOSS

I, Kris Elaine T. Abique, of legal age, Filipino, single and a resident of 1800 J. Nakpil
St. Paco, Manila, after having been duly sworn to in accordance with law, depose and state:

1. That I am a holder of Automated Teller Machine (ATM) Card No. 6018539067650857 duly
issued in my favor by Banco de Oro.

2. That I used to put said ATM card in my wallet;

3. That sometime on January 14, 2014 when I arrived home from work, I discovered that said
ATM card was no longer in my wallet;

4. That diligent effort to locate the same proved futile;

5. That I bind myself to save BDO harmless from any loss or damage that it may incur in
connection with the issuance of a new ATM card in lieu of the lost one;

6. That I am executing this affidavit to attest to the foregoing facts and for any legal purpose it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 16th day of January
2014 in Paco, Metro Manila, Philippines.



KRIS ELAINE T. ABIQUE
Affiant

SUBCRIBED AND SWORN TO before me this 16th day of JANUARY 2014 in Paco, Metro
Manila, Philippines, affiant exhibiting to me his valid proof of identification.

Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2013.