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REPUBLIC OF THE PHILIPPINES)

CITY OF ILIGAN ) S. S.

AFFIDAVIT OF LOSS

I, MINOMBAO LUCMAN DOMATO, 69 years old, widow,


and a resident of Rosario Heights, Iligan City, after having been duly
sworn to in accordance with law, hereby depose and say, that:

1. I am a retired Principal 1 of Gata, Poona-Bayabao, Lanao


del Sur, Division of Lanao del Sur 1;

2. On May 23, 2018, during the Marawi siege, we left our


home in Lilod and evacuated here in Iligan City. A few
months passed and we learned that our house was burned to
the ground;

3. After the liberation of Marawi City from the Maute group,


we went back to the erstwhile invaded city to check our
property. It was then that we confirmed our house was
indeed a total wreck. We were not able to salvage anything
on our visit. Among the lost belongings is my appointment
paper, CS Form No. 33-A;

4. We have concluded that all the things inside our property


was destroyed and now beyond recovery; and

5. This Affidavit is executed to attest to the truth of the


foregoing statement.

IN WITNESS WHEREOF, I have hereunto set my hand and


affixed my signature this 26th day of October 2018, at Iligan City,
Philippines.

MINOMBAO LUCMAN DOMATO


Affiant

SUBSCRIBED AND SWORN to before me on the date and


place above-written by the Affiant.
REPUBLIC OF THE PHILIPPINES)
CITY OF ILIGAN ) S. S.

AFFIDAVIT OF EXPLANATION

I, MINOMBAO LUCMAN DOMATO, 69 years old, widow,


and a resident of Rosario Heights, Iligan City, after having been duly
sworn to in accordance with law, hereby depose and say, that:

1. I am a retired Principal 1 of Gata, Poona-Bayabao, Lanao


del Sur, Division of Lanao del Sur 1;

2. On June 2014, I was supposed to file for my terminal leave


benefits, unfortunately I had kidney trouble so I decided to
seek medical help first and foremost. I then focused on my
medication and hospitalization that I forgot to process said
terminal leave benefits; and

3. This Affidavit is executed to attest to the truth of the


foregoing statement and to explain the delay in the filing of
the terminal leave benefits.

IN WITNESS WHEREOF, I have hereunto set my hand and


affixed my signature this 26th day of October 2018, at Iligan City,
Philippines.

MINOMBAO LUCMAN DOMATO


Affiant

SUBSCRIBED AND SWORN to before me on the date and


place above-written by the Affiant.

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