Republic of the Philippines }

City of Dumaguete } S.S.

AFFIDAVIT OF LOSS

I, CRAMWEL R. OMATANG, of legal age, Filipino, with residence and postal address at
Mag-abo, Amlan, Negros Oriental, after having been duly sworn to in accordance with law hereby depose
and state that:

1. I am presently employed with LBP Service Corporation assigned at Bangko Sentral ng

Pilipinas (BSP) Dumaguete Branch as Utility Foreman.

2. By virtue of my employment, I was issued an Identification Card;

3. Said Identification Card was lost sometime on July 5, 2019 at an unknown location;

4. Hereunder are the facts and circumstances surrounding the loss of my Identification Card:

On July 5, 2019 after my work at BSP Dumaguete Branch, I put my ID card in one of my
pockets and I drove home using my motorcycle. I happened to stop over in the talipapa
market located at Airport Area, Sibulan, Negros Oriental to buy some fish. As far as I
remember, I got some money to pay for the fish I bought in the same pocket where I
placed my ID. Upon reaching home, when I was about to get my ID on my pocket to hang
it on the place where I usually put it when I arrive at my home, I have noticed that the
same was lost.

5. I made diligent search to recover the said Identification Card but proved futile;

6. For all legal intents and purposes the said Identification Card is now considered lost and
beyond recovery;

7. I am executing this affidavit to attest to the truth of the foregoing and for whatever legal
purpose/s it may serve.

FURTHER AFFIANT SAYETH NAUGHT.

IN TRUTH THEREOF, I have hereunto set my hand this 8 th day of July 2019, at Dumaguete City,
Negros Oriental, Philippines.

CRAMWEL R. OMATANG
Affiant

SUBSCRIBED AND SWORN to before me this ___________________ day of

______________________ 2019, affiant exhibited to me his valid identification UMID Card No. CRN-
0006-2236538-5 issued by the Social Security System (SSS).

NOTARY PUBLIC

Doc. No. ___________;

Page No. ___________;
Book No. ___________;
Series of 2019.