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REPUBLIC OF THE PHILIPPINES )

MEYCAUAYAN, BULACAN) SS.

AFFIDAVIT OF LOSS

I, Lali aquino, Filipino, of legal age, single, and a resident of 4777 Bunducan
Bocaue, Bulacan, after having been duly sworn in accordance with law, hereby depose
and say:

1. That I am a holder of an Access ID;

2. That I used to put said Access ID in my wallet;

3. That sometime on September 21, 2018, when I tried to look for my wallet
including my Access ID in the place where I usually put it, I could not find it;

4. That I have exerted all the efforts needed to find it but to no avail;

5. That the said Access ID is now lost and beyond recovery;

6. That I am executing this affidavit to attest to the truth of the foregoing facts and
to use it for all intents and legal purposes and to request for its replacement.

IN WITNESS WHEREOF, I have hereunto affixed my signature this September,


20, 2018 at Meycauayan, Bulacan, Philippines.

___________________________
AFFIANT

Before me a Notary Public for and in Meycauayan, Bulacan, personally


appeared lali aquino on September 22, 2018, who exhibited to me her SSS ID
No. 23333333333.

Notary Public
Doc. No.;
Page No.;
Book No. ;
Series of 2018.

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