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AFFIDAVIT OF LOSS
I, (NAME), (age), Filipino, single and a resident in (ADDRESS), after having been duly sworn
to in accordance with law, hereby depose and state THAT:
(__NAME__)
Affiant
SUBSCRIBED AND SWORN TO before me this 3rd day of May 2018 at (CITY),
Philippines, affiant being personally known to me and exhibiting his ID, as competent
evidence of identity under the 2004 RULES OF NOTARIAL PRACTICE.