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REPUBLIC OF THE PHILIPPINES)

________________________ )S.S.

AFFIDAVIT OF LOSS
(Contract Policy)

I, ___________________________ of legal age, Filipino, and with


residence and postal address at
__________________________________________ after being duly sworn
to in accordance with law, hereby depose and say that:

1. I am a Planholder of PRUDENTIALIFE PLANS INC., having been


issued a Life/ Pension/ Educational Plan under contract no.
___________________

2. Said contract policy was inadvertently lost.

3. Inspite of diligent efforts to look for said contact policy all such
efforts proved futile and in vain up to this time, thus, I am declaring
the loss of the said contract policy.

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


facts and for all its legal intents, effects, consequences and
purposes.

_________________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this


____________________ at ______________________.

Doc. No. ____


Page No. ____
Book No. ___
Series of 2013.
REPUBLIC OF THE PHILIPPINES)
LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, JOHNNY LIMSOC JR., of legal age, Filipino, and with residence and
postal address at Lot 5 Block 1, Maple St., Phase 2, Greenwood Village,
Cainta Rizal, after being duly sworn to in accordance with law, hereby
depose and say that:

1. I am a holder of educational plan policy and certificate of full


payment issued by Prudentialife Plans Inc., under policy/contract
no. 73358720

2. Said policy and certificate of full payment was inadvertently lost.

3. Inspite of diligent efforts to look for said policy and certificate of


full payment all such efforts proved futile and in vain up to this time, thus, I
am declaring the loss of the said policy and certificate of full payment.

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


facts and for all its legal intents, effects, consequences and purposes.

JOHNNY LIMSOC JR.


Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this August 17, 2013


at Las Pinas City.

Doc. No. 425


Page No. 87
Book No. 72
Series of 2013.
REPUBLIC OF THE PHILIPPINES)
LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, JOHNNY LIMSOC JR., of legal age, Filipino, and with residence and
postal address at Lot 5 Block 1, Maple St., Phase 2, Greenwood Village,
Cainta Rizal, after being duly sworn to in accordance with law, hereby
depose and say that:

1. I am a holder of pension plan policy and certificate of full payment


issued by Prudentialife Plans Inc., under policy/contract no.
53678334

2. Said policy and certificate of full payment was inadvertently lost.

3. Inspite of diligent efforts to look for said policy and certificate of


full payment all such efforts proved futile and in vain up to this time, thus, I
am declaring the loss of the said policy and certificate of full payment.

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


facts and for all its legal intents, effects, consequences and purposes.

JOHNNY LIMSOC JR.


Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this August 17, 2013


at Las Pinas City.

Doc. No. 426


Page No. 88
Book No. 72
Series of 2013.
SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, JOHNNY LIMSOC JR., of legal age, Filipino, and with residence and postal
address at Lot 5 Block 1, Maple St., Phase 2, Greenwood Village, Cainta Rizal, do
hereby constitute, appoint and name, JOHNNY LIMSOC III, of legal age, Filipino
and resident of #10 Governor E. Rodriguez St., Zone 5, Signal Village, Taguig City,
to be my true and lawful attorney-in-fact, for me and in my name, place and stead,
concerning my Education Plan with PRUDENTIALIFE PLANS, INC., under
Policy/Contract No. 73323668 issued by Prudentialife Plans Inc., to do and perform
the following: - the following:

To claim, receive, collect, whether in cash or check the proceeds of said


plan; to cause, if within the said companys agreement, to have the said benefits
payable, to sign, seal, execute any contract/s, agreement/s, receipts, compromises,
waivers, quitclaims, affidavits, papers or writings with the said company; to make
payments as are considered acts of dominion; to compromise; to waive
gratuitously, accept, recognize and novate any agreement or contract concerning
our obligations; and, in case of collection is received in check/s in my name, to
encash, endorse, rediscounts, deposit said check/s and endorse, to make deposits
or negotiate the aforesaid check/s and to have the said company remove or cancel
the crossed check/s with for deposit to account or similar import notations in the
said check/s so that the same can be converted to cash proceeds forthwith upon
negotiation with the drawee-bank; to perform any other powers to accomplish the
purposes of this special power of attorney, be it implied, inherent or inferred from
the express powers herein.

GIVING AND GRANTING unto my said attorney-in-fact full power and


authority to do and perform all and every act and thing whatsoever requisite,
convenient or necessary to be done in and about the premises as fully to all intents
and purposes as I might or could do if personally present; and HEREBY
RATIFYING AND CONFIRMING, and all that my said attorney-in-fact shall
lawfully do or cause to be done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand at Las Pias City on


this August 17, 2013.

JOHNNY LIMSOC JR JOHNNY LIMSOC III


Principal ATTY.-IN-FACT

WITNESSES: ______________________ _________________________

REPUBLIC OF THE PHILIPPINES)


LAS PIAS CITY )S. S.

BEFORE ME, a Notary Public for and in Las Pias City, this August 17, 2013
personally appeared principal, with his identification card consisting of:
___________________________ known to me and to me known to be the same
person who executed the foregoing Special Power of Attorney, and who
acknowledged to me that the same is her free and deed.

WITNESS MY HAND AND NOTARIAL SEAL.


Doc. No. ____
Page No. ___
Book No. ____
Series of ______.
SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, JOHNNY LIMSOC JR., of legal age, Filipino, and with residence and postal
address at Lot 5 Block 1, Maple St., Phase 2, Greenwood Village, Cainta Rizal, do
hereby constitute, appoint and name, JOHNNY LIMSOC III, of legal age, Filipino
and resident of #10 Governor E. Rodriguez St., Zone 5, Signal Village, Taguig City,
to be my true and lawful attorney-in-fact, for me and in my name, place and stead,
concerning my Education Plan with PRUDENTIALIFE PLANS, INC., under
Policy/Contract No. 73358720 issued by Prudentialife Plans Inc., to do and perform
the following: - the following:

To claim, receive, collect, whether in cash or check the proceeds of said


plan; to cause, if within the said companys agreement, to have the said benefits
payable, to sign, seal, execute any contract/s, agreement/s, receipts, compromises,
waivers, quitclaims, affidavits, papers or writings with the said company; to make
payments as are considered acts of dominion; to compromise; to waive
gratuitously, accept, recognize and novate any agreement or contract concerning
our obligations; and, in case of collection is received in check/s in my name, to
encash, endorse, rediscounts, deposit said check/s and endorse, to make deposits
or negotiate the aforesaid check/s and to have the said company remove or cancel
the crossed check/s with for deposit to account or similar import notations in the
said check/s so that the same can be converted to cash proceeds forthwith upon
negotiation with the drawee-bank; to perform any other powers to accomplish the
purposes of this special power of attorney, be it implied, inherent or inferred from
the express powers herein.

GIVING AND GRANTING unto my said attorney-in-fact full power and


authority to do and perform all and every act and thing whatsoever requisite,
convenient or necessary to be done in and about the premises as fully to all intents
and purposes as I might or could do if personally present; and HEREBY
RATIFYING AND CONFIRMING, and all that my said attorney-in-fact shall
lawfully do or cause to be done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand at Las Pias City on


this August 17, 2013.

JOHNNY LIMSOC JR JOHNNY LIMSOC III


Principal ATTY.-IN-FACT

WITNESSES: ______________________ _________________________

REPUBLIC OF THE PHILIPPINES)


LAS PIAS CITY )S. S.

BEFORE ME, a Notary Public for and in Las Pias City, this August 17, 2013
personally appeared principal, with his identification card consisting of:
___________________________ known to me and to me known to be the same
person who executed the foregoing Special Power of Attorney, and who
acknowledged to me that the same is her free and deed.

WITNESS MY HAND AND NOTARIAL SEAL.


Doc. No. ____
Page No. ___
Book No. ____
Series of ______.
SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

I, JOHNNY LIMSOC JR., of legal age, Filipino, and with residence and postal
address at Lot 5 Block 1, Maple St., Phase 2, Greenwood Village, Cainta Rizal, do
hereby constitute, appoint and name, JOHNNY LIMSOC III, of legal age, Filipino
and resident of #10 Governor E. Rodriguez St., Zone 5, Signal Village, Taguig City,
to be my true and lawful attorney-in-fact, for me and in my name, place and stead,
concerning my Pension Plan with PRUDENTIALIFE PLANS, INC., under
Policy/Contract No. 53678334 issued by Prudentialife Plans Inc., to do and perform
the following: - the following:

To claim, receive, collect, whether in cash or check the proceeds of said


plan; to cause, if within the said companys agreement, to have the said benefits
payable, to sign, seal, execute any contract/s, agreement/s, receipts, compromises,
waivers, quitclaims, affidavits, papers or writings with the said company; to make
payments as are considered acts of dominion; to compromise; to waive
gratuitously, accept, recognize and novate any agreement or contract concerning
our obligations; and, in case of collection is received in check/s in my name, to
encash, endorse, rediscounts, deposit said check/s and endorse, to make deposits
or negotiate the aforesaid check/s and to have the said company remove or cancel
the crossed check/s with for deposit to account or similar import notations in the
said check/s so that the same can be converted to cash proceeds forthwith upon
negotiation with the drawee-bank; to perform any other powers to accomplish the
purposes of this special power of attorney, be it implied, inherent or inferred from
the express powers herein.

GIVING AND GRANTING unto my said attorney-in-fact full power and


authority to do and perform all and every act and thing whatsoever requisite,
convenient or necessary to be done in and about the premises as fully to all intents
and purposes as I might or could do if personally present; and HEREBY
RATIFYING AND CONFIRMING, and all that my said attorney-in-fact shall
lawfully do or cause to be done by virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand at Las Pias City on


this August 17, 2013.

JOHNNY LIMSOC JR JOHNNY LIMSOC III


Principal ATTY.-IN-FACT

WITNESSES: ______________________ _________________________

REPUBLIC OF THE PHILIPPINES)


LAS PIAS CITY )S. S.

BEFORE ME, a Notary Public for and in Las Pias City, this August 17, 2013
personally appeared principal, with his identification card consisting of:
___________________________ known to me and to me known to be the same
person who executed the foregoing Special Power of Attorney, and who
acknowledged to me that the same is her free and deed.

WITNESS MY HAND AND NOTARIAL SEAL.


Doc. No. ____
Page No. ___
Book No. ____
Series of ______.

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