REPUBLIC OF THE PHILIPPINES)

CITY OF CEBU ) S.S.

AFFIDAVIT OF LOSS
I, JAMES REID , of legal age, Norwegian National, married, and resident of Bulubogan,
Tajao, Pinamungajan Cebu, Philippines, after being duly sworn according to law, hereby
depose and state that:

1. That I am a Norwegian Citizen and for that they issue me a

Norwegian Passport bearing No. NOR 12738947 issued on 24 August
2010 valid until 24 August 2025;

2. That I am also a permanent resident of the Philippines and for that

they issue me an Alien Certificate of Registration Identity-Card (ACR
I-Card for brevity);

3. That on September 21,2017 at around 2:00 o’clock in the afternoon,

when I was riding a taxi and dropped along National Hi-way
fronting Abellana National School, Cebu City, I forgot my bag;

4. That the above-said identification cards was inside my bag

including all other id’s which I could no longer remember;

5. That the above-said identification cards was unfortunately lost by

me and diligent search proved futile;

6. That I am executing this Affidavit to attest to the truth of the

foregoing circumstances and for the purpose of the re-issuance of
new Norwegian Passport and ACR I-Card card in lieu of the lost one;

IN WITNESS WHEREOF,I have hereto set my hands this ____ day of

November, 2017 in Cebu City, Philippines.

JAMES REID
Affiant
Driver’s License Id G10-00-008349
Issued on November 19, 2017
valid until November 19, 2020
Issued at LTO Cebu City, Philippines.
 SUBSCRIBED AND SWORN TO before me this ____day of November 9, 2017
at Cebu City, Philippines.

Doc. No _____
Page No. ____
Book No.____
Series of 2017.