REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO
)Sc.
x-----------------------------x
AFFIDAVIT OF LOSS
of PASSPORT
I, AILEEN L. BODEJAS, of legal age, Filipino, and residing at
Brgy. Salacay, Cabatuan, Iloilo, Philippines, after having been sworn
to in accordance with law, do hereby declare and state:
1.
I am applying for a passport replacement with the
Department of Foreign Affairs, Iloilo Office, for my lost passport which
was issued to me in Iloilo and expired last 2002;
2. I used to be an Overseas Foreign Worker (OFW) working as
Domestic Helper in Singapore from 1998-2000;
3. When I came back to the Philippines sometime in 2003, I left
my passport with a recruitment agency in Manila, whose name I
could no longer recall, to re-apply for employment abroad and came
back home to Iloilo;
4. When I came back to Manila to follow-up my application, the
recruitment agency told me that my passport could no longer be
found;
5. Despite diligent efforts to locate my passport, the same
could no longer be found, thus I consider it lost for all legal intents
and purposes;
6. I am applying again for a replacement passport for I intend to
accompany my son, AXL ROSE BODEJAS, in traveling abroad
sometime in the future;
7. This affidavit is executed for the purpose of attesting to the
fact of the loss of my old passport as well as for my application for
the issuance of a new passport.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hand this 8 th
day of January 2007 in the City of Iloilo Philippines.

________________________
AILEEN L. BODEJAS
(Affiant)
SUBSCRIBED
AND
SWORN
to
before
me
this
______________________ at Iloilo City, affiant showing to me her

Community Tax Certificate No. 15931193 issued at Sta. Rosa City,

Laguna on 05 January 2007 as Competent Evidence of Identity.
Doc. No. : _________;
Page No.: _________;
Book No.: _________;
Series of 2007.