REPUBLIC OF THE PHILIPPINES)

BATANGAS CITY ) S.S.

AFFIDAVIT OF LOSS

I, CHARMIN C. FALLARNA, single, of legal age, Filipino,

and a resident of Sta. Rita Ilaya, Batangas Citry, after having
been duly sworn to, in accordance with law, hereby, depose and
say THAT:

1. I am a member of the Card SME Bank, hence, an

identification card was issued to me;

2. It was recently when I discovered upon organizing my

personal files that said Card SME Bank ID is missing;

3. I exerted diligent efforts to find and locate the said ID

but the same proved futile;

4. Moreover, said ID has not been returned,

surrendered, nor found by any finder/keeper;

5. I am executing this Affidavit of Loss to attest to the

truth of the above stated facts and to apprise the proper
authorities as to the truth of such facts and for whatever legal
purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

13 August 2019 at Batangas City.

CHARMIN C. FALLARNA
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 13

August 2019, at Batangas City, affiant, personally known to me.

MICKEL M. BORIGAS
Notary Public
Doc. No. ___; Until 31 December 2019
Page No. __; PTR No. 3308863 01-03-19 Batangas City
Book No. ___; IBP LM No. 012668 Batangas City
Series of 201_. Roll No. 63423 Serial No. 2017-31
MCLE Comp. No. VI-0021819
Valid until 04.14.2022
Zenaida Arcade, 43 M.H. del Pilar St.,
Batangas City