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Republic of the Philippines)

Olongapo City .) S.S.

AFFIDAVIT OF LOSS
I, JOHN MICHAEL RIPOTOLA, of legal age, Filipino, married, with residential
address at NO. 1249 Baltazar St., Sta. Rita, Olongapo City, Zambales, Philippines, after
having duly sworn to in accordance with law, hereby depose and state:
1.

That I am presently employed at the SBMA Seaport Department located at


the Subic Bay Freeport Zone, Philippines;

2.

That I have a personal time deposit account at the Metrobank, Subic


Bay Freeport Branch, and I was able to obtain certificates of my time
deposit with the said bank;

3.

That sometime last May 2013, I go over my personal documents and I


noticed that my certificates of time deposit with Metrobank were
nowhere to be found and I surmise that the same was lost somewhere;

4.

Despite diligent effort to locate the said certificates of time deposit with
the Metrobank, Subic Bay Freeport Branch, all efforts proved fruitless
as up to the present and fear that the same has been lost beyond
recovery; and

5.

I am executing this affidavit of loss to attest to the truth of the foregoing


and for whatever legal purpose it may serve.

AFFIANT FURTHER SAYETH NAUGHT.


IN WITNESS WHEREOF, we have hereunto affix my signature this 4th day of
July 2013, at Subic Bay Freeport Zone, Olongapo City, Philippines.

JOHN MICHAEL RIPOTOLA


- Affiant
SUBSCRIBED AND SWORN to before me this 4th day of July, 2013 at Subic
Bay Freeport Zone. Affiants exhibited to me his valid LTO Non-Professional Drivers
License No. N01-00-247625, as proof of their personal identification.
Doc No.: 406;
Page No. 83;
Book No.
9;
Series of 2013.