Republic of the Philippines )

Camiling, Tarlac )S.S.

AFFIDAVIT OF LOSS
I, MARK ANTHONY OBISPO VALDEZ, 27 years old, Filipino citizen, single
and a resident of Barangay San Isidro, Camiling, Tarlac, Philippines, after having
been duly sworn to in accordance with law do hereby depose and say THAT;

1. On June 20, 2017 in the morning, I boarded a passenger jitney from

Guadalupe, Makati City going to Bonifacio Global City, Taguig City. I
brought with me my wallet which contained my Postal Identity Card and
Student Drivers License Receipt, some cash and other personal
belongings;

2. While in transit, I discovered that my wallet was missing;

3. Right away, I searched for it underneath my seat but I found nothing.

Also, I asked some of my co-passengers if they have seen the same but
all answered in the negative;

4. All the diligent efforts exerted to locate my wallet and its contents proved
futile; hence, I now consider them as lost and beyond recovery;

5. The said student drivers license receipt and postal identity card were
never confiscated by any authority nor pledged to secure any obligations;

6. I am executing this affidavit to attest to the truth of the foregoing

statements and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 6th day of

July, 2017 at Camiling, Tarlac, Philippines.

MARK ANTHONY O. VALDEZ

Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicated

above. Affiant exhibited before me his Police Clearance with Control No.
20170314002 issued by the Camiling Police Station, Camiling, Tarlac on March 14,
2017.

Doc. No.:______;
Page No.:______;
Book No.:______;
Series of 2017.