REPUBLIC OF THE PHILIPPINES) PROVINCE OF SULTAN KUDARAT) S. S.

MUNICIPALITY OF KALAMANSIG) X-------------------------------------------X

AFFIDAVIT OF LOSS

I, SSupt Enrique Hortillosa y Menaje (Ret), 65 years old, married, and a resident of Brgy. Poblacion, Kalamansig, Sultan Kudarat, after having been duly sworn to in accordance with law depose and say: That, I am a registered holder of a old PNP ID issued by the Philippine National Police, Camp Crame, Quezon City. That at about 9:30 oclock in the morning of July 30, 2011, while on our way from Lebak to Kalamansig, Sultan Kudarat, I notice that my wallet to include my PNP ID and some important document was lost. That I exerted my effort to recover or locate tha same but all in vain; That I am executing this affidavit for the purpose of informing the Officer or Officers of the Philippine National Police of any of its duly authorized representatives that my PNP ID was lost and I am requesting that be issued a new one. That all the statement declared herein are all true and correct. IN WITNEES WHEREOF, I have hereunto set my hand this 16th day of August 2011, at Kalamansig, Sultan Kudarat.

SSUPT ENRIQUE HORTILLOSA y MENAJE (Ret) Affiant

SUBCRIBED AND SWORN to before me this 16th day August 2011, at Kalamansig, Sultan Kudarat, Philippines. FELIXBERTO T ANGGANA Police Inspector PNP DEPOIC