Republic of the Philippines )

City of Naga]

AFFIDAVIT

I, xxxxxxxx, of legal age, Filipino, and with residence and postal address
at xxxxx, after having been duly sworn to in accordance with law, hereby deposes
and says:

1.) That sometime on September 2019, I went to Social Security

System (SSS) Naga City to receive my SSS ID;

2.) That an employee from SSS told me that my SSS ID was sent
through registered mail to my mailing address;

3.) That I never received such SSS ID and neither was it in the
possession of the Post Office – Sipocot branch upon
verification;

4.) Thus, for all intents and purposes, said SSS ID shall be
deemed irrecoverable;

5.) That I am executing this Affidavit to obtain a new SSS ID;

6.) That I attest to the truth of all the foregoing and for all legal
purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of

October, 2019 at xxxx, Philippines.

xxxxxxx
Affiant

SUBSCRIBED AND SWORN TO before me this 7th day of October, 2019 at

xxxx, Philippines, with the above-named affiant identifying himself through her
Postal ID xxxxx and that she further avow, under the penalty of law, to the truth
of the foregoing.

Doc. No.
Page No.
Book No.
Series of 2018