X---------------------------------------X AFFIDAVIT OF LOSS I, TIFFANY A. BERBANO, of legal age, Filipino, single and a resident of Waray Drive, Don Alfaro St., Tetuan, Zamboanga City, after having been sworn to in accordance with law, hereby depose and state: 1. That I am the holder of the Philippine Health Insurance Corp., Identification Card (PHILHEALTH ID) and Tax Identification Number (TIN); 2. That said ids were regularly placed in my wallet for identification purposes; 3. That on March 28, 2016, due to an inadvertence, I discovered that the same were no longer in my wallet and consider it lost for all legal intents and purposes; 4. That I am executing this affidavit to attest to the veracity of the foregoing statements and for the issuance of a new one in lieu of the loss. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my signature this 5th day of April, 2016 at Zamboanga City, Philippines.
TIFFANY A. BERBANO Affiant SUBSCRIBED AND SWORN to before me on the above date and place.
REPUBLIC OF THE PHILIPPINES)
CITY OF ZAMBOANGA..) S.S. X---------------------------------------X AFFIDAVIT OF LOSS I, ANGELIE LEONG, of legal age, Filipino, single and a resident of Sta. Maria, Zamboanga City, after having been sworn to in accordance with law, hereby depose and state: 5. That I am the accountant of Golden Haven Memorial Park Inc.; 6. That said office paid the required amount for the printing of official receipt to be surrendered to Freedom Commercial Printers, Inc. as accredited by BIR and was issued an Authority to Print and Form 1906; 7. That on October 23, 2015, I am about to surrender said forms and the same can no longer be found along with my other documents where I kept; 8. That due to an inadvertence, the same can no longer be found and consider it lost for all legal intents and purposes;
9. That I am executing this affidavit to attest to the
veracity of the foregoing statements and for the printing of the requested official receipts of our company. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my signature this 6th day of November, 2015 at Zamboanga City, Philippines.
ANGELIE LEONG Affiant SUBSCRIBED AND SWORN to before me on the above date and place.
REPUBLIC OF THE PHILIPPINES)
CITY OF ZAMBOANGA..) S.S. X---------------------------------------X AFFIDAVIT OF LOSS I, RIFAT A. CUEVAS, of legal age, Filipino, single and a resident of Tetuan, Zamboanga City, after having been sworn to in accordance with law, hereby depose and state: 10. That I am a previous employee of Primeplus Promotion & Outsourcing Inc., as Merchandiser; 11. That on August 6, 2015, I was terminated for said employment and was issued a Waiver/Quitclaim thereof;
12. That sometime in the first week of October, 2015,
when I was about to claim my separation pay, I noticed that the original copy of my Waiver/Quitclaim was no longer in my folder along with my other documents where I kept; 13. That due to an inadvertence, the same can no longer be found and consider it lost for all legal intents and purposes; 14. That I am executing this affidavit to attest to the veracity of the foregoing statements and for the issuance of a new one in lieu of the loss. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my signature this 7th day of October, 2015 at Zamboanga City, Philippines. RIFAT A. CUEVAS Affiant SUBSCRIBED AND SWORN to before me on the above date and place.
REPUBLIC OF THE PHILIPPINES)
CITY OF ZAMBOANGA..) S.S. X---------------------------------------X AFFIDAVIT OF LOSS
I, FREDESVINDO C. FABIAN, of legal age, Filipino, married
and a resident of Zambowood, Zamboanga City, after having been sworn to in accordance with law, hereby depose and state: 15. That I am a holder and a member of the Philippine Health Insurance Corp., (PHILHEALTH), Zamboanga City and was issued an identification card; 16. That said card was regularly placed in my cabinet at home for safe keeping; 17. That sometime on the month of September, 2015, due to an inadvertence, I discovered that the same was no longer where I kept and can no longer be found and consider it lost for all legal intents and purposes; 18. That I am executing this affidavit to attest to the veracity of the foregoing statements and for the issuance of a new one in lieu of the loss. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my signature this 6th day of October, 2015 at Zamboanga City, Philippines. FREDESVINDO C. FABIAN Affiant Senior Citizen ID No. 039610 SUBSCRIBED AND SWORN to before me on the above date and place.
REPUBLIC OF THE PHILIPPINES)
CITY OF ZAMBOANGA..) S.S. X---------------------------------------X AFFIDAVIT OF LOSS I, ZOREN KIER T. MIGUEL, of legal age, Filipino, single and a resident of Tomas Claudio Ext., Zamboanga City, after having been sworn to in accordance with law, hereby depose and state: 19. That I am a holder and a member of the Philippine Health Insurance Corp., (PHILHEALTH), Zamboanga City and was issued an identification card; 20. That said card was regularly placed inside my wallet for safe keeping; 21. That sometime on the month of June, 2015, due to an inadvertence, I discovered that the same was no longer in my wallet and can no longer be found and consider it lost for all legal intents and purposes; 22. That I am executing this affidavit to attest to the veracity of the foregoing statements and for the issuance of a new one in lieu of the loss. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my signature this 5th day of August, 2015 at Zamboanga City, Philippines. ZOREN KIER T. MIGUEL Affiant SUBSCRIBED AND SWORN to before me on the above date and place.