REPUBLIC THE PHILIPPINES)

BATANGAS CITY ) S.S.

AFFIDAVIT OF LOSS

I, MARY ANN E. GUEVARRA-ARANGO, married, of legal age, Filipino,

and a resident of Taal, Batangas, after having been duly sworn to in accordance
with law, hereby, depose, and state that:

[1] I am a holder of a Professional Regulation Commission (PRC)

Identification Card with No. 114004, issued by the Office of the PRC;

[2] Recently, while I was searching for the said identification card, I
have discovered that the same was lost;

[3] I exerted diligent efforts to find and locate the said item but the
same proved futile;

[4] Moreover, said item has not been returned to me;

[5] I am executing this affidavit to attest to the truth of all the

foregoing facts, to inform the proper authorities and for whatever legal purpose
this Affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 11 July

2018, at Batangas City.

MARY ANN E. GUEVARRA-ARANGO

Affiant
PRC ID No. 0045154

SUBSCRIBED AND SWORN TO BEFORE ME this 11 July 2018, at

Batangas City, affiant, exhibited to me her ID with number stated above.

MICKEL M. BORIGAS
Notary Public
Doc. No. 384; Until 31 December 2019
Page No. 78; PTR No. 3022551 01-04-18 Batangas City
Book No. V; IBP LM No. 012668 Batangas City
Series of 2018. Roll No. 63423 Serial No. 2017-31
MCLE Comp. No. V-0021813 Valid until 04.12.2019
Zenaida Arcade, 43 M.H. del Pilar St., Batangas City

Page 1 of 1
Affidavit of Loss