Affidavit of Loss Wallet With ID

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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAVITE )
MUNICIPALITY OF TANZA )

AFFIDAVIT OF LOSS
I, APRIL ROSE SOTO. GARCIA, of legal age, single, Filipino and presently
residing at Block 8 Lot 37, Monterra Verde Subdivision, Tanza, Cavite, after having been
duly sworn to in accordance with law, do herby depose and state:
1. I was a member of Social Security System (SSS) with SS No. 33-7809346-1
and issued a SSS Identification Card, Also, I was issued a PRULIFE UK ID;

2. That sometime on September, 2020, I was on my way home when I discovered


that my wallet, which I inserted on my bag was missing;

3. My wallet contained some cash and the said SSS identification card and
PRULIFE UK identification card;

4. Efforts were exerted to locate said wallet, but in spite of diligent search, it
could not be found and the same is now beyond recovery;

5. That in order to protect my interest, I am executing this Affidavit of Loss in


order to notify SSS and PRULIFE UK office about this loss, as well as to
request for issuance of new or replacement;

That in order to protect my interest, I am executing this Affidavit of Loss to attest


to the truth of the foregoing and to support my application for the issuance of a new
Professional Driver’s License, Original OR/CR and my ATM card in lieu of the one that
lost;
IN WITNESS WHEREOF, I have hereinto set my hand this
_________________ in __________________________________Philippines.

_______________________________
April Rose Soto Garcia
Affiant

SUBSCRIBED AND SWORN TO BEFORE me this __________________


at ______________________. Affiant exhibiting me his/her TIN id with No. 230-138-
313-000, with photograph and signature through which I had been able to confirm his
identity.

Doc. No.________
Page No.________
Book No.________
Series of 2020

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