Republic of the Philippines )

Province of Rizal ) s.s

AFFIDAVIT OF LOSS

I, RESURRECCION C. CRUZ, of legal age, Filipino, with residence and

postal address at Blk. 16 Melon St. Sitio Lambak Floodway Brgy. San Juan
Taytay, Rizal, after having been duly sworn to in accordance with law, hereby
depose and state:

1. That I am the owner and holder of the following Identification Cards:

a) Veterans Bank ID
b) Coop Card issued by the Development Bank of the Philippines
c) Umid card issued by the Government Security Insurance System
d) PAG-IBIG – Citi Bank Card
e) Voter’s ID issued by the Commission on Elections
f) Barangay ID
g) Solo Parent ID;
2. That due to an unforeseeable circumstance, my handbag has been
recently stolen;
3. That the said Identification Cards were inside the said handbag when
it was taken away from me;
4. That despite diligent search and efforts to locate the said
Identification Cards, I could not find them, such that I now believe
that they are now lost beyond recovery
5. That I am executing this affidavit to attest to the truth of the foregoing
and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereby set my hand this 8th day of February

2017 at Antipolo City.

RESURRECCION C. CRUZ
Affiant

SUBSCRIBED AND SWORN to before me this 8th day of February, 2017

at Antipolo City, Affiant exhibited to me her Government ID issued by the
Province of Rizal, with the number 590133 0100 02541 1.

NOTARY PUBLIC

Doc. No. ___________

Page No. ___________
Book No. ___________
Series of 2017.