Republic of the Philippines )

City of Dipolog ) S.S

x------------------------------------x

AFFIDAVIT OF LOSS

I, LESTER L. ZAPATOS, Filipino, of legal age, single and a resident of Brgy.

Lower Dicayas, Dipolog City, Zamboanga del Norte, after having duly sworn in
accordance with law, do hereby depose and state that:

1. That I am the holder of Postal ID issued last February 2017, at Dipolog City,
Zamboanga del Norte;

2. That sometime on March, 2018, I discovered that my Postal ID was probably

lost or misplaced and despite diligent efforts to locate or retrieve it, the same
could not be located;

3. That I am executing this affidavit to attest to the truth of the foregoing facts
for the purpose of requesting new Postal ID at Dipolog City, Zamboanga del
Norte.

IN WITNESS WHEREOF, I have hereunto affixed our hands this____ day of

_______________ at Dipolog City, Philippines.

LESTER L. ZAPATOS

Affiant

SUBSCRIBE AND SWORN TO before me this ______________ at Dipolog City,

Philippines, with affiant exhibiting his Drivers License No. JO1-14-000820, issued at
LTO,Dipolog City, Zamboanga del Norte.

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Series of 2018.
Republic of the Philippines )
City of Dipolog ) S.S
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AFFIDAVIT OF LOSS

I, FREDERICK S. CALOG, of legal age, Filipino, married and a resident of

Barangay Alvinda, Mutia, Zamboanga del Norte, after having duly sworn in accordance
with law, do hereby depose and state that:

1. That I am a holder of an Official Receipt from a purchase of a chainsaw in

Oroquieta City in the year 2017 which is more particularly described as
follows:
BRAND SERIAL MACHINE NO.

ZERO70 STEEL S178200084

2. That the said document while in my possession was misplaced and could no
longer ne located inspite of exerting efforts of locating them;

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

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, we have hereunto affixed our hands this____ day of

_______________ at ________________.

FREDERICK S. CALOG
Affiant
Philhealth ID 16-050166521-2

SUBSCRIBE AND SWORN TO before me this August 31, 2018 at Dipolog City.

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Series of 2018.