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REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.


x ------------------------------------------- x
AFFIDAVIT OF LOSS
I, CHERRY BITANGCOL BALANAG, of legal age, Filipino
Citizen, married and currently residing at Simsim Compound, Maria
Basa, Pacdal, Baguio City, on oath, states:
1. I was issued by the Department of Foreign Affairs a passport
sometime in 2002 which shall expire in 2007.
2. I have kept the said Passport together with my other significant
documents inside a folder.
3. Last 2003, we resided in an apartment located in Rimando
Road, Baguio City, but had transferred again to another
apartment located in New Lucban, Baguio City last 2004. In
2008, however, we moved to our current residence at Simsim
Compound, Maria Basa, Pacdal, Baguio City.
4. During the span of time where we were required to transfer our
things from one apartment to another, I have misplaced the said
folder where I kept my Passport and other documents.
5. Despite diligent efforts I exerted to recover the said Passport,
the same proved futile and fruitless hence I considered it lost
and beyond point of recovery.
6. The abovementioned Passport was neither confiscated for any
violation of any laws, rules or regulations nor was it delivered to
any person to guaranty the performance of any obligation.
7. I am now executing this affidavit to attest to the veracity of the
foregoing narration for securing a replacement of the said lost
passport and for all legal intents and purposes it may serve.
IN WITNESS, I have hereunto set my hand this 15th day of
March 2016, in the City of Baguio, Philippines.
______________________________
CHERRY BITANGCOL BALANAG
Affiant
SUBSCRIBED AND SWORN to before me, in the City of
Baguio, Philippines, this 15th day of March 2016. Affiant personally
appeared and exhibited to me her Social Security System ID No. 33-

5550485-0, who executed and personally signed the foregoing


affidavit before me and acknowledged that she executed the same.

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