AFFIDAVIT OF LOSS

REPUBLIC OF THE PHILIPPINES)

CITY OF DAVAO) S.S

I, Zoren R. Reyes, of legal age, single and residing at Misamis St., Insular
Viilage, Davao City, after having been duly sworn to according to law hereby depose
and state that:

1. I am the owner of a BDO Automated Teller Machine Card with card

number 5201 2899 4067 8838

2. On the 2nd of December 2019 with a number of books and packages I was
carrying while getting out of my car, my wallet containing the above-
mentioned ATM card must have slipped from my pocket because after I
reached my office, I hurriedly tried to get my wallet from my pocket but it
was not there anymore;

3. After diligent search inside my car and the stairs and elevator used going
up to my office, my said ATM card was nowhere to be found anymore;

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

circumstances and for the purpose of reporting the loss to Banco De Oro
Network Bank.

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of

December, 2019 at the City of Davao.

__________________
Affiant
SUBSCRIBED AND SWORN to before me, this 10th day of December, in the City
of Davao, by Zoren R. Reyes with Driver’s License No. L07-19-002399 issued on
Oct. 10, 2018 at Davao City, Philippines.

ATTY. FAITH IMEE D. ROBLE

Notary Public for Davao City
Commission Serial No. 88888
Until Dec. 31, 2020
Attorney’s Roll No. 70888
PTR No. 12345– 02/18/19 – D.C.
IBP No. 54321– 02/18/19 – D.C.
Doc. No.____ Rm. 1E, Anda Corporate Center, Anda St.,
Page No.____ Davao City, 8000, Philippines
Book No.____ Contact No.: (+63)945-445-6912
Series of 2019. E-mail Address: faithimeeroble@gmail.com