REPUBLIC OF THE PHILIPPINES

City Of Baguio ) SS.

AFFIDAVIT OF LOSS
I, Mae Ann Y. Badua, of legal age and residing/with address at Lot 7, Block 8, Easter
Hills Subd., Lower Pinget, Baguio City, under oath, state:
1.

THAT on 28 February 2005 while riding on a jeepney on my way home, my wallet

was pick-pocketed without my knowledge;

2.

THAT my wallet contained my school ID, my Drivers License and some money

bills;
3.

THAT I exerted diligence efforts to locate my wallet or identify the culprit but to no

avail and I therefore considered the same as lost and cannot be found;
4.

THAT I am executing this Affidavit to attest to the truth of the foregoing facts and

to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this 10th of January 2016 at
Baguio City, Philippines.

Mae Ann Y. Badua

Affiant

SUBSCRIBED AND SWORN to before me this 1st of February 2016 at Baguio City,
Philippines, Affiant exhibiting to me his Community Tax Certificate bearing No.
26431issued at Baguio City on 21st of December 2014.
Doc No. ________;
Page No. _______ ;
Book No. _______;
Series of 2005.