Aff Loss of Passport

Republic of the Philippines)
Silang, Cavite ) S.S.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS OF PASSPORT
I, ANAROSE DOLOSA ASKALI, Filipino, of legal age, single and residing at Block 108, Lot
14, Camia St., Heritage Springhomes, Barangay Puting Kahoy, Silang, Cavite, after having been
duly sworn to in accordance with law do hereby depose and say that:
1. I am the holder and possessor of a Philippine Passport duly issued to me by Department of

Foreign Affairs (DFA), Davao;
2. Last September 04, 2022, I and my friend Elgyn Abong Puerto went to NBI, Tagaytay City,
Cavite to secure and obtain NBI Clearance and brought with us our Passport which was
securely place in a plastic envelope for safekeeping;
3. After we obtained our Clearance, we left NBI, Tagaytay City, Cavite and we then boarded on
a passenger jeepney on our way home;
4. However, upon alighted in Barangay Puting Kahoy, Silang, Cavite, I and my friend noticed
that the plastic envelope containing my passport was missing and I believe that the same
was left inside the passenger jeepney and despite all diligent efforts exerted to locate my
aforesaid passport but in vain and nowhere to be found;
5. The said passport has not been encumbered, sold, pledged, assigned, alienated,
transferred, donated, or given as a collateral for any debt or obligation to or in favor of any
person or entity;
6. I further understand that said passport will be immediately deemed cancelled and may no
longer be used for travel or other purposes. As such, in case the passport is found or
retrieved undersigned will immediately surrender it to the Department of Foreign Affairs;
7. I executed this affidavit to attest to the truth and veracity of the foregoing statements; to
apprise proper authorities concerned for the loss of my passport and to request for the
issuance of a new passport in lieu of the lost one and for all legal intents and purposes this
may serve.
IN WITNESS WHEREOF, I hereunto signed below.
ANAROSE DOLOSA ASKALI

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 13 th day of October,
2022 personally appeared ANAROSE DOLOSA ASKALI with her National ID No. 5493-8125-3276-
4580 issued on 06 December 2021, presenting the above affidavit who is personally known to me
or identified by me through competent evidence of identity as defined by the National Rules as the
person who signs the document and in my presence taken an oath or affirmation before me as to
such document. WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE-
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.
x- - - - - - - - - - - - - - - - - - x
I, ELGYN ABONG PUERTO, Filipino, of legal age, married and residing at Block 108, Lot
14, Camia St., Heritage Springhomes, Barangay Puting Kahoy, Silang, Cavite, after having been
duly sworn to in accordance with law do hereby depose and say that:
8. I am the holder and possessor of a Philippine Passport bearing number P2241013B duly
issued to me by Department of Foreign Affairs (DFA), General Santos on 22 May 2019 and
valid until 21 May 2029;
9. Last September 04, 2022, I and my friend Anarose Dolosa Askali went to NBI, Tagaytay
City, Cavite to secure and obtain NBI Clearance and brought with us our Passport which
was securely place in a plastic envelope for safekeeping;
10. After we obtained our Clearance, we left NBI, Tagaytay City, Cavite and we then boarded on
a passenger jeepney on our way home;
11. However, upon alighted in Barangay Puting Kahoy, Silang, Cavite, I and my friend noticed
that the plastic envelope containing my passport was missing and I believe that the same
was left inside the passenger jeepney and despite all diligent efforts exerted to locate my
person or entity;
may serve.
ELGYN ABONG PUERTO

Affiant
2022 personally appeared ELGYN ABONG PUERTO with her Philhealth ID No. 15-201608545-0,
presenting the above affidavit who is personally known to me or identified by me through
competent evidence of identity as defined by the National Rules as the person who signs the
document and in my presence taken an oath or affirmation before me as to such document.
WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE-WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.
x- - - - - - - - - - - - - - - - - - x
I, MAIREN MATIENZO PEREY, Filipino, of legal age, married and residing at 051
St. Paul Street, Barangay Miguel Mojica, Mendez, Cavite, after having been duly sworn to
in accordance with law do hereby depose and say that:
15. I am the holder and possessor of a Philippine Passport duly issued to me by

Department of Foreign Affairs (DFA), Manila;
16. I usually place my said Passport inside my bag which was kept in our house in 051
St. Paul Street, Barangay Miguel Mojica, Mendez, Cavite for safekeeping;
17. Unfortunately, on January 05, 2018, when I checked the same in my bag, I noticed
that my passport was missing inside my bag and despite all diligent efforts exerted
to locate my aforesaid passport but in vain and nowhere to be found;
transferred, donated, or given as a collateral for any debt or obligation to or in favor
of any person or entity;
19. I further understand that said passport will be immediately deemed cancelled and
may no longer be used for travel or other purposes. As such, in case the passport is
found or retrieved undersigned will immediately surrender it to the Department of
Foreign Affairs;
20. I executed this affidavit to attest to the truth and veracity of the foregoing statements;
to apprise proper authorities concerned for the loss of my passport and to request
for the issuance of a new passport in lieu of the lost one and for all legal intents and
purposes this may serve.
MAIREN MATIENZO PEREY

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 7 th day of
October, 2022 personally appeared MAIREN MATIENZO PEREY with her UMID CRN-
0111-1737883-1, presenting the above affidavit who is personally known to me or
identified by me through competent evidence of identity as defined by the National Rules
as the person who signs the document and in my presence taken an oath or affirmation
before me as to such document. WITNESS MY HAND AND SEAL
Atty. IRINEO ON THE PLACE AND
A. ANARNA
DATE FIRST ABOVE-WRITTEN. Notary Public for the Province of Cavite
Commission No. TG-20-009, valid until Dec. 31, 2022
Roll of Attorneys No. 32080
IBP No. 01666/ Lifetime Member
Doc. No. 280; PTR No. 5498388 / 1-03-2022 / TMC
MCLE No. VII ---- 0003161 / May 15, 2021 / valid until April 14, 2025
Page No. 57; No. 4 Madlansacay St., Poblacion 2, Silang, Cavite
Book No. 329;
Series of 2022.
x- - - - - - - - - - - - - - - - - - x
I, ANNABELLE M. LOVERO, Filipino, of legal age, widow and residing at Regency

Townhomes, Sampaloc II, Dasmariñas City, Cavite, after having been duly sworn to in accordance
with law do hereby depose and say that:
Foreign Affairs (DFA), Manila;
22. Last September 26, 2022, I went to NSN in Silang Public Market, Silang, Cavite to buy some
stuffs and brought along with me my aforesaid passport which was kept in my bag;
23. However, upon reaching home, I noticed that my passport was missing and I believe that
same fell unnoticed from my bag and despite all diligent efforts exerted to locate my
person or entity;
may serve.
ANNABELLE M. LOVERO
Affiant
2022 personally appeared ANNABELLE M. LOVERO with her Postal ID No. PRN E95210590631
P issued by Post Office Taytay, Rizal and valid until December 02, 2024, presenting the above
affidavit who is personally known to me or identified by me through competent evidence of identity
as defined by the National Rules as the person who signs the document and in my presence taken
an oath or affirmation before me as to such document. WITNESS MY HAND AND SEAL ON THE
PLACE AND DATE FIRST ABOVE-WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.
x- - - - - - - - - - - - - - - - - - x
I, JOHN MARTIN B. DEJARO, Filipino, of legal age, single, with residence address at
Barangay Tapi, Kabankalan City, Negros Occidental and presently a stay-in worker At Starkson
Corporation, Brgy. Lalaan, Silang, Cavite, after having been duly sworn to in accordance with law
do hereby depose and say that:
Foreign Affairs (DFA);
28. Last February 7, 2021, I went to Manila to seek for a job abroad and brought along with me
my aforesaid passport which was kept in a brown envelope, after inquiries from an agency, I
boarded on a passenger bus heading Silang, Cavite;
29. However, as I was travelling, I don’t feel well and my head is terribly aching, thus, when I
reached my destination, particularly in Lalaan, Silang, Cavite, I hurriedly alighted from the
said bus, hence, I forgot to bring with me my brown envelop where my passport was kept;
30. I exerted diligent efforts exerted to locate my aforesaid passport but in vain and nowhere to
be found;
person or entity;
may serve.
JOHN MARTIN B. DEJARO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 26 th day of September,
2022 personally appeared JOHN MARTIN B. DEJARO with his NBI ID No. D260LJSN39-
DJ741613 and valid until June 08, 2023, presenting the above affidavit who is personally known to
me or identified by me through competent evidence of identity as defined by the National Rules as
the person who signs the document and in my presence taken an oath or affirmation before me as
to such document. WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE-
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.
x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, IVY ROSE CAMAYAN PASANG-BATALLA, Filipino, of legal age, married and residing at
Sitio Hanopol, Barangay Kaong, Silang, Cavite, after having been duly sworn to in accordance with
law do hereby depose and say that:
34. I am the holder and possessor of a Philippine Passport bearing passport number
P7053478B issued to me by Department of Foreign Affairs (DFA), NCR North on 28 June
2021 and valid until 27 June 2031;
35. I securely place my said passport inside my cabinet in my house for safekeeping;
36. Sometime in December 2021, when I checked the same, I noticed that my said passport
was missing and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
IVY ROSE CAMAYAN PASANG-BATALLA

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 1 st day of September,
2022 personally appeared IVY ROSE CAMAYAN PASANG-BATALLA with her UMID CRN-0111-
9497680-3, presenting the above affidavit who is personally known to me or identified by me
through competent evidence of identity as defined by the National Rules as the person who signs
the document and in my presence taken an oath orAtty.affirmation
IRINEO before me as to such document.
A. ANARNA
WITNESS MY HAND AND SEAL ON THE PLACE AND NotaryDATE FIRST
Public for ABOVE-WRITTEN.
the Province of Cavite
Doc. No. ____; IBP No. 01666/ Lifetime Member
Page No. ____; PTR No. 5498388 / 1-03-2022 / TMC
Book No. ____; MCLE No. VII ---- 0003161 / May 15, 2021 / valid until April 14, 2025
No. 4 Madlansacay St., Poblacion 2, Silang, Cavite
Series of 2022.
x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, FLORENCIO MUGAR ESTRADA, Filipino, of legal age, married and residing at Sikap
Ville, Barangay Sabutan, Silang, Cavite, after having been duly sworn to in accordance with law do
hereby depose and say that:
40. I am the holder and possessor of a Philippine Passport issued to me by Department of

41. I securely place my said Passport inside the tool box of my tricycle for safekeeping;
42. However, on April 28, 2022, when I checked the same, I noticed that my said passport was
missing and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
FLORENCIO MUGAR ESTRADA

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 30 th day of August,
2022 personally appeared FLORENCIO MUGAR ESTRADA with his Driver’s License ID No. D18-
05-005723 issued by LTO and valid until 2032/02/23, presenting the above affidavit who is
personally known to me or identified by me through competent evidence of identity as defined by
the National Rules as the person who signs the document and in my presence taken an oath or
affirmation before me as to such document. WITNESS MY HAND AND SEAL ON THE PLACE
AND DATE FIRST ABOVE-WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.
Atty. IRINEO A. ANARNA
Notary Public for the Province of Cavite
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, JURIX ASOY CANGGAS, Filipino, of legal age, single and with permanent address at
Proper Dimaya Dinas, Zamboanga Del Sur, after having been duly sworn to in accordance with law

Foreign Affairs (DFA), Zamboanga City;
47. On August 23, 2022, I arrived in Manila and my cousin Jaime Damgo Jr. fetched me at
Ninoy Aquino International Airport (NAIA) Terminal 3;
48. I brought along with me my passport which was kept inside my brown envelope for
safekeeping;
49. I and my cousin then boarded on a passenger bus from Pasay City going to Silang, Cavite;
50. However, upon reaching my cousin’s house at Purok 3, Lalaan I, Silang, Cavite, I noticed
that my brown envelope containing my passport and PSA copy of my certificate of live birth
were missing and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
JURIX ASOY CANGGAS

Affiant
2022 personally appeared JURIX ASOY CANGGAS with his Philhealth ID No. 14-201800395-2,
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022. Atty. IRINEO A. ANARNA
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, EDITHA ANDAYA VILLALUNA, Filipino, of legal age, single and residing at Barangay
Lalaan I, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
54. I am the holder and possessor of a Philippine Passport bearing number P6684877B issued
to me by Department of Foreign Affairs (DFA), NCR South on 22 April 2021 and valid until
21 April 2031;
55. On October 29, 2021, I boarded on a passenger bus going to Manila to seek for a job
abroad, I brought along with me my passport which was kept inside my bag for safekeeping;
56. After inquiries, I left Manila and I then boarded on a passenger bus going to Silang, Cavite;
57. However, while travelling to Silang Cavite I fell asleep and when I woke up at Silang, Cavite,
I noticed that my bag containing my passport was missing and despite all diligent efforts
exerted to locate it but in vain;
person or entity;
may serve.
EDITHA ANDAYA VILLALUNA

Affiant
2022 personally appeared EDITHA ANDAYA VILLALUNA with her Philhealth ID No. 08-
the document and in my presence taken an oath or affirmation before me as to such document.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022. Notary Public for the Province of Cavite
PTR No. 5498388 / 1-03-2022 / TMC
x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, BEULAH YVEN ROBLES MALUBAY, Filipino, of legal age, single and with permanent
address at 86 Paradise Street, Matain, Subic, Zambales, after having been duly sworn to in
accordance with law do hereby depose and say that:
61. I am the holder and possessor of a Philippine Passport bearing number P7761157A issued
to me by Department of Foreign Affairs (DFA), Megamall, Manila;
62. I securely place my said passport inside my bag for safekeeping;
63. On April 17, 2022, I went to a restaurant in Silang, Cavite and had a dinner with my family
and brought my bag with me containing my said passport;
64. However, upon reaching home in 2570 By Pass Road, Barangay San Vicente II, Silang,
Cavite, I noticed that my bag containing my said Passport was missing and despite all
diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
BEULAH YVEN ROBLES MALUBAY

Affiant
2022 personally appeared BEULAH YVEN ROBLES MALUBAY with her Driver’s License ID No.
N01-22-311291 issued by LTO and valid until 2027/01/18, presenting the above affidavit who is
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, MAC DHARELL JANAP MENDOZA, Filipino, of legal age, single and residing at 039
Purok I, Barangay Balubad 1st, Silang, Cavite, after having been duly sworn to in accordance with

69. I securely place my said passport in my cabinet at my house for safekeeping;
70. However, on July 11, 2022, when I checked the same, I discovered that my said Passport
person or entity;
may serve.
MAC DHARELL JANAP MENDOZA

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 13 th day of July, 2022
personally appeared MAC DHARELL JANAP MENDOZA with his UMID CRN-0111-7327041-0,
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

Republic of the Philippines) IBP No. 01666/ Lifetime Member
Silang, Cavite ) S.S. PTR No. 5498388 / 1-03-2022 / TMC
x- - - - - - - - - - - - - - - - - - x No. 4 Madlansacay St., Poblacion 2, Silang, Cavite
AFFIDAVIT OF LOSS
I, REMELYN OBTINALLA MONTEMAYOR, Filipino, of legal age, single and residing at 087
Barangay Maitim II East, Tagaytay City, Cavite, after having been duly sworn to in accordance with

75. I securely place my said passport in my plastic envelope for safekeeping;
76. Sometime in February 2017, my said Passport was misplaced and despite all diligent efforts
exerted to locate it but in vain;
person or entity;
may serve.
REMELYN OBTINALLA MONTEMAYOR

Affiant
personally appeared REMELYN OBTINALLA MONTEMAYOR with her UMID CRN-0111-1638342-
9, presenting the above affidavit who is personally known to me or identified by me through
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

Silang, Cavite ) S.S. Atty. IRINEO A. ANARNA
x- - - - - - - - - - - - - - - - - - x Notary Public for the Province of Cavite
AFFIDAVIT OF LOSS
PTR No. 5498388 / 1-03-2022 / TMC
I, HAIDILYN ROBEA BELLEN, Filipino, ofNo.legal age, widow
4 Madlansacay and residing
St., Poblacion at 397 Purok 4,
2, Silang, Cavite
Kanluran, Barangay Adlas, Silang, Cavite, after having been duly sworn to in accordance with law

81. I securely place my said passport in my cabinet at my house in my residence address
above-mentioned for safekeeping;
82. Sometime in March 2019, when I checked the same, I noticed that my Passport was missing
in my cabinet and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
HAIDILYN ROBEA BELLEN

Affiant
personally appeared HAIDILYN ROBEA BELLEN with her National ID No. 4825-0698-3791-5894
issued on August 04, 2021, presenting the above affidavit who is personally known to me or
identified by me through competent evidence of identity as defined by the National Rules as the
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, MARITES GONZALES ENDRINAL, Filipino,Notary Public
of legal for single
age, the Province
and of Cavite at Barangay
residing
Hoyo, Silang, Cavite, after having been duly sworn to in Roll
accordance
of Attorneys No. 32080do hereby depose
with law
and say that: IBP No. 01666/ Lifetime Member
PTR No. 5498388 / 1-03-2022 / TMC
87. On May 27, 2022, I boarded on a passenger bus going to Manila to seek for a job abroad, I
brought along with me my passport which was kept in a plastic envelope;
88. After inquiries, I left Manila and I then boarded on a passenger bus going to Silang, Cavite;
89. However, upon alighted in Silang, Cavite, I noticed that my plastic envelope containing my
said was missing and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
MARITES GONZALES ENDRINAL

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 30 th day of June, 2022
personally appeared MARITES GONZALES ENDRINAL with her UMID CRN-0111-3778011-1,
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, RICKY ZAUSA SALAZAR, Filipino, of legal age, married and residing at 197 Kap. Pepe
St., Barangay V (Poblacion), Silang, Cavite, after having been duly sworn to in accordance with
93. I am the holder and possessor of a Philippine Passport
Commission issuedvalid
No. TG-20-009, to until
meDec.
by 31,
Department
2022 of
Foreign Affairs (DFA), Manila; Roll of Attorneys No. 32080
PTR No. 5498388 / 1-03-2022 / TMC
94. I securely place my said passport in my cabinet at my house for safekeeping;
95. Sometime in June 2008, when I checked the same, I noticed that my Passport was missing
in my cabinet and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
RICKY ZAUSA SALAZAR

Affiant
personally appeared RICKY ZAUSA SALAZAR with his Driver’s License ID No. N03-22-006089
issued by LTO and valid until 2026/05/02, presenting the above affidavit who is personally known
to me or identified by me through competent evidence of identity as defined by the National Rules
as the person who signs the document and in my presence taken an oath or affirmation before me
as to such document. WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST
ABOVE-WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, ELVIE LAGOS ALCOCISAR, Filipino, of legal age, married and with permanent address
at Sitio Malasaga, Katilingban, City of Talisay, NegrosAtty. IRINEO
Occidental, A. ANARNA
after having been duly sworn to
in accordance with law do hereby depose and say that:Notary Public for the Province of Cavite
99. I am the holder and possessor of a Philippine Passport bearing
IBP No. 01666/ number
Lifetime Member P6416647A issued
to me by Department of Foreign Affairs (DFA),PTR Bacolod on 14
No. 5498388 March 2018
/ 1-03-2022 / TMC and expires on
13 March 2028; No. 4 Madlansacay St., Poblacion 2, Silang, Cavite
100.On May 30, 2022, I boarded on a passenger bus going to Manila to seek for a job abroad, I
brought along with me my passport which was kept in a plastic envelope;
101.After inquiries, I left Manila and I then boarded on a passenger bus going to Silang, Cavite;
102.However, when I reached my brother’s house located at Block 65, Lot 11, Buklod Bahayan,
Tartaria, Silang, Cavite, I noticed that my passport was missing in my plastic envelope and
despite all diligent efforts exerted to locate it but in vain;
103.The said passport has not been encumbered, sold, pledged, assigned, alienated,
person or entity;
104.I further understand that said passport will be immediately deemed cancelled and may no
105.I executed this affidavit to attest to the truth and veracity of the foregoing statements; to
may serve.
ELVIE LAGOS ALCOCISAR

Affiant
personally appeared ELVIE LAGOS ALCOCISAR with her National ID No. 4018-0538-6325-0610
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, MAURINE PAMPLONA ALVAREZ, Filipino, of legal age, married and residing at 129
Purok 6, Barangay Carmen, Silang, Cavite, after having been duly sworn to in accordance with law
106.I am the holder and possessor of a Philippine Passport bearing duly issued to me by
Department of Foreign Affairs (DFA), Lucena;
107.I securely place my said Passport inside my cabinet at my house for safekeeping;
108.Sometime in January 2020, when I checked the same in my cabinet, I discovered that my
Philippine passport was missing and despite all diligent efforts exerted to locate the same
but to no avail;
109.The said passport has not been encumbered, Atty. sold,

IRINEO pledged,
A. ANARNA assigned, alienated,
transferred, donated, or given as a collateral for any debt or obligation
Notary Public for the Province of toCavite
or in favor of any
person or entity; Commission No. TG-20-009, valid until Dec. 31, 2022
PTR No. 5498388 / 1-03-2022 / TMC
may serve.
MAURINE PAMPLONA ALVAREZ

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 21 st day of June, 2022
personally appeared MAURINE PAMPLONA ALVAREZ with her UMID CRN-0111-0892880-5,
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, JAN ARRIANE RAMOS BAYTAN, Filipino, of legal age, single and residing at 107 Santan
St., Mary Ann Village, Brgy. 5 (Poblacion), Silang, Cavite, after having been duly sworn to in
112.I am the holder and possessor of a Philippine Passport bearing number P2224863A issued
to me by Department of Foreign Affairs (DFA), Manila on 09 March 2017 and expires on 08
March 2022
113.I securely place my said passport in a folder and kept the same inside our house for
safekeeping;
114.Sometime in March 2022, when I was searching for my said passport for the renewal of the
same, I discovered that my Philippine Passport was missing and despite all diligent efforts
exerted to locate it but in vain; Atty. IRINEO A. ANARNA
115.The said passport has not been encumbered, Commission No.sold, pledged,
TG-20-009, valid untilassigned,
Dec. 31, 2022 alienated,
Rolldebt
transferred, donated, or given as a collateral for any of Attorneys No. 32080
or obligation to or in favor of any
person or entity; PTR No. 5498388 / 1-03-2022 / TMC
116.I further understand that said passport will No.
be4immediately
Madlansacay St.,deemed
Poblacion 2,cancelled
Silang, Cavite
and may no
may serve.
JAN ARRIANE RAMOS BAYTAN

Affiant
personally appeared JAN ARRIANE RAMOS BAYTAN with her Driver’s License ID No. D18-15-
003932 issued by LTO and valid until 2032/04/29, presenting the above affidavit who is personally
known to me or identified by me through competent evidence of identity as defined by the National
Rules as the person who signs the document and in my presence taken an oath or affirmation
before me as to such document. WITNESS MY HAND AND SEAL ON THE PLACE AND DATE
FIRST ABOVE-WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, CARMI ORTIZ BAYOT, Filipino, of legal age, single and residing at Purok 4, Barangay
Lalaan II, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
118.I am the holder and possessor of a Philippine Passport bearing number P7350399B issued
to me by Department of Foreign Affairs (DFA), Dasmariñas on August 06, 2021 and expires
on August 05, 2031;
119.Sometime in December 2021, I went to Trece Martires City, Cavite and obtained PSA copy
of my certificate of live birth. I brought along with me my passport which was kept in a brown
envelope for my identification;
120.After my transaction to the Philippine Statistics Authority (PSA), I left Trece Martires, Cavite
and I then boarded on a passenger bus going to Dasmariñas, Cavite and upon reaching my
destination I boarded again to a passenger jeepney going to Silang, Cavite;
121.However, while travelling to Silang Cavite I fell asleep and when I woke up at the Silang
Town Proper of Silang, Cavite, I noticed that my brown envelope containing my passport
person or entity;
may serve.
IN WITNESS WHEREOF, I hereunto signed below. No. TG-20-009, valid until Dec. 31, 2022
Commission
PTR No. 5498388 / 1-03-2022 / TMC
No. CARMI ORTIZ
4 Madlansacay BAYOT2, Silang, Cavite
St., Poblacion
Affiant
personally appeared CARMI ORTIZ BAYOT with her UMID CRN-0111-7843874-9, presenting the
above affidavit who is personally known to me or identified by me through competent evidence of
identity as defined by the National Rules as the person who signs the document and in my
presence taken an oath or affirmation before me as to such document. WITNESS MY HAND AND
SEAL ON THE PLACE AND DATE FIRST ABOVE-WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, ELVIE LAGOS ALCOCISAR, Filipino, of legal age, married and with permanent address
at Sitio Malasaga, Katilingban, City of Talisay, Negros Occidental, after having been duly sworn to
to me by Department of Foreign Affairs (DFA), Bacolod on 14 March 2018 and expires on
13 March 2028;
126.On May 30, 20222, I boarded on a passenger bus going to Manila to seek for a job abroad,
I brought along with me my passport which was kept in a plastic envelope;
127.After inquiries, I left Manila and I then boarded on a passenger bus going to Silang, Cavite;
128.However, when I reached my brother’s house located at Block 65, Lot 11, Buklod Bahayan,
Tartaria, Silang, Cavite, I noticed that my passport was missing in my plastic envelope and
despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
ELVIE LAGOS ALCOCISAR

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 2 nd day of June, 2022
personally appeared ELVIE LAGOS ALCOCISAR with her National ID No. 4018-0538-6325-0610
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
I, RACHELLE ANN TERRADO AMOROSO, Filipino, of legal age, single and residing at
164 Barangay Biga 1, Silang, Cavite, after having been duly sworn to in accordance with law do
to me by Department of Foreign Affairs (DFA), NCR Northeast on 05 June 2017 and expires
on 04 June 2022;
Atty.
133.Last August 23, 2021 at around 8:00 o’clock in the IRINEO
morning IA. ANARNA
boarded on a passenger bus
Notary Public for the Province
going to Manila to seek for a job abroad, I brought along with me my of passport
Cavite which was
kept in a small pouch bag; Roll of Attorneys No. 32080
134.After inquiries, I left Manila at around 3:00 o’clock
PTR No. in the afternoon.
5498388 / 1-03-2022 /I TMC then boarded on a
passenger bus going to Silang, Cavite; No. 4 Madlansacay St., Poblacion 2, Silang, Cavite
135.As I was on the passenger bus, I fixed my things. I took out my pouch bag from my bag,
when I reached my destination, I hurriedly alighted in the bus without checking of my
belongings;
136.Thus, when I was in my house, I discovered that my pouch bag including my passport was
missing and left it in the bus and despite all diligent efforts exerted to locate it but in vain;
person or entity;
may serve.
RACHELLE ANN TERRADO AMOROSO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 2 nd day of June, 2022
personally appeared RACHELLE ANN TERRADO AMOROSO with her TIN ID Card No. 298-260-
066-000 issued on 09/22/2010 by BIR, presenting the above affidavit who is personally known to
me or identified by me through competent evidence of identity as defined by the National Rules as
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, SHERWIN CATABAY LUNA, Filipino, of legal age, single and residing at Purok 1,
Barangay Pulong Bunga, Silang, Cavite, after having been duly sworn to in accordance with law do
140.I am the holder and possessor of a Philippine Passport duly bearing passport number
Atty. IRINEO
P0359405A issued on 23 September 2016 by Department A. ANARNA
of Foreign Affairs (DFA), Manila
and valid until 22 September 2021; Commission No. TG-20-009, valid until Dec. 31, 2022
141.I securely place my said Passport inside my cabinet at my
IBP No. house
01666/ for Member
Lifetime safekeeping;
PTR No. 5498388 / 1-03-2022 / TMC
142.Sometime in April 2022, when I checked the same in my cabinet, I discovered that my
Philippine passport was missing and despite all diligent efforts exerted to locate the same
but to no avail;
person or entity;
may serve.
SHERWIN CATABAY LUNA

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 19 th day of May, 2022
personally appeared SHERWIN CATABAY LUNA with his TIN ID No. 290-633-911-000 issued on
07/11/2014 by BIR, presenting the above affidavit who is personally known to me or identified by
me through competent evidence of identity as defined by the National Rules as the person who
signs the document and in my presence taken an oath or affirmation before me as to such
document. WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE-
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x Atty. IRINEO A. ANARNA
I, MELLIZA DIGNO LABORTE, Filipino, of legal No.
PTR 5498388
age, / 1-03-2022
married / TMC
and residing at Purok 1,
Barangay Malaking Tatiao, Silang, Cavite, after having been dulySt.,sworn
No. 4 Madlansacay to 2,inSilang,
Poblacion accordance
Cavite with law
146.I am the holder and possessor of a Philippine Passport duly bearing passport number
P8403886B issued on 07 December 2021 by Department of Foreign Affairs (DFA), Manila
and valid until 06 December 2031;
147.Last, April 29, 2022, I went to the Town Proper of Silang, Cavite and brought with me my
plastic envelope containing my said passport and other important documents and
photocopied the same. However, few days later, I noticed that my passport was missing and
I believe that the same fell unnoticed from my plastic envelope and despite all my diligent
efforts exerted to locate the same but to no avail. I also went to the establishment where I
photocopied my said passport and other documents and asked them if they saw my said
Passport but no one saw it;
person or entity;
may serve.
MELLIZA DIGNO LABORTE

Affiant
personally appeared MELLIZA DIGNO LABORTE with her Voter’s ID No. 2118-0303A-
E0981MDL20000 issued by Comelec Silang, Cavite, presenting the above affidavit who is
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - x

I, MARK CHRISTIAN EUSEBIO VIDAL, Filipino, of legal
Notary Public age,
for the single
Province and residing at 14
of Cavite
Yakal St., Barangay San Miguel I, Silang, Cavite, after having
Commission been valid
No. TG-20-009, dulyuntil
sworn to 2022
Dec. 31, in accordance
with law do hereby depose and say that:
PTR No. 5498388 / 1-03-2022 / TMC
151.I am the holder and possessor of a MCLE
Philippine
No. VII ---- Passport
0003161 / May duly
15, 2021bearing passport
/ valid until April 14, 2025 number
P8431062A issued on 20 August 2018 by Department of Foreign Affairs (DFA), Manila and
valid until 19 August 2028;
152.Sometimes in June 2021, I went to Comelec of Silang, Cavite and applied for my National
identification card and brought with me my said passport for my identification. After my
application for my National ID, I boarded on a tricycle on my way home and placed my
passport in my pocket for safekeeping. However, upon reaching home, I noticed that my
passport was missing and I believe that the same fell unnoticed from my pocket and despite
all my diligent efforts exerted to locate the same but to no avail. I also went to the terminal of
Tricycle in Silang, Cavite and asked all the tricycle drivers if they saw my said Passport but
no one saw it;
person or entity;
may serve.
MARK CHRISTIAN EUSEBIO VIDAL

Affiant
personally appeared MARK CHRISTIAN EUSEBIO VIDAL with his Police Clearance Card with
Control No. SMPS-M-004636 issued on May 17, 2022 by Silang Cavite Police Station and valid
until September 17, 2022, presenting the above affidavit who is personally known to me or
WRITTEN.
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

Republic of the Philippines) Notary Public for the Province of Cavite
Silang, Cavite ) S.S. Roll of Attorneys No. 32080
x- - - - - - - - - - - - - - - - - - x IBP No. 01666/ Lifetime Member
PTR No. 5498388 / 1-03-2022 / TMC
I, JONG HANG KIM, Korean National, of legal age, married and presently residing at
Royale Tagaytay, Backestate, Alfonso, Cavite, after having been duly sworn to in accordance with
156.I am the holder and possessor of a Korean Passport bearing passport number M77755941
issued on 25 February 2016 by Ministry of Foreign Affairs and valid until 25 February 2026;
157.However, on April 26, 2022 at about 2:00 to 3:00 o’clock in the afternoon, I went to Mang
Inasal located at Premier Plaza, Barangay. Lucsuhin, Silang, Cavite to eat and then I
brought with me my said passport for my identification. However, while eating in the said
place, I placed my said Korean Passport beside my chair. Unfortunately, when I was about
to get my Korean passport after done eating in the said fast food chain, I noticed that my
said Korean passport was missing and despite all my diligent efforts exerted to locate the same
but to no avail;
person or entity;
retrieved undersigned will immediately surrender it to the Korean Embassy in the
Philippines;
may serve.
JONG HANG KIM

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 28 th day of April, 2022
personally appeared JONG HANG KIM with his Korean Driver’s License ID No. 13-87-615634-91
issued on April 8, 2022 and valid until December 31, 2028, presenting the above affidavit who is
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.

PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - x
I, JULITA HERNANDEZ LAGORAS, Filipino, of legal age, married and presently residing at
Barangay Adlas, Silang, Cavite, after having been duly sworn to in accordance with law do hereby
depose and say that:
161.I am the holder and possessor of a Philippine Passport duly issued by Philippine Embassy
(PE) of Doha, Qatar which I securely placed inside an envelope at my house for
safekeeping;
162.However, on April 01, 2022, my envelope containing my said passport was misplaced and
despite all my diligent efforts exerted to locate the same but to no avail;
person or entity;
may serve.
JULITA HERNANDEZ LAGORAS

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 21 st day of April, 2022
personally appeared JULITA HERNANDEZ LAGORAS with her SSS ID No. 33-4992821-9,
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022.
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - -x
I, CRISCELLE JANE ALCOVER, Filipino, of legal age, single and presently residing at
Cardinal Subdivision Barangay Sampaloc I, Dasmariñas, Cavite, after having been duly sworn to in
166.I am the holder and possessor of a Philippine Passport bearing number EB7025983 duly
issued by Department of Foreign Affairs, Manila on 27 December 2012 and expires on 26
December 2017;
167.I securely placed my said passport inside my cabinet in my rented apartment before at
Barangay Lucsuhin, Silang, Cavite for safekeeping;
168.However, on February 14, 2021, when I checked the same inside my cabinet, I discovered
that my said Passport was missing and despite all my diligent efforts exerted to locate the same
but to no avail;
person or entity;
may serve.
CRISCELLE JANE ALCOVER

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 25 th day of March,
2022 personally appeared CRISCELLE JANE ALCOVER with her Postal ID No. PRN
D73190513936 issued by Post Office Silang, Cavite and valid until October 21, 2022, presenting
the above affidavit who is personally known to me or identified by me through competent evidence
of identity as defined by the National Rules as the person who signs the document and in my
Doc. No. ____;

Page No. ____;
Book No. ____;
PTR No. 5498388 / 1-03-2022 / TMC
x- - - - - - - - - - - - - - - - - - -x
I, EDISON MANRIQUE MAAC, Filipino, of legal age, single and residing at Barangay
Kaong, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
172.I am the holder and possessor of a Philippine Passport bearing passport number
EB6963260 duly issued by Department of Foreign Affairs, Manila on 17 December 2012 and
expires on 16 December 2017;
173.Sometime in 2017, I went to a computer shop in Bulihan, Silang, Cavite and brought with
me my said passport to photocopy the same. After I photocopied my said passport, I placed
it inside my pocket for safekeeping. However, upon reaching home, I discovered that my
said Passport was missing and I believe that the same fell unnoticed from my pocket and
despite all my diligent efforts exerted to locate the same but to no avail;
person or entity;
may serve.
EDISON MANRIQUE MAAC

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 23rd day of March,
2022 personally appeared EDISON MANRIQUE MAAC with his Professional Driver’s License ID
No. D04-15-011319 issued by LTO and valid until 2023/04/19, presenting the above affidavit who
is personally known to me or identified by me through competent evidence of identity as defined by
Doc. No. ____;

Page No. ____; Atty. IRINEO A. ANARNA
Book No. ____; Commission No. TG-20-009, valid until Dec. 31, 2022
Series of 2022. Roll of Attorneys No. 32080
PTR No. 5498388 / 1-03-2022 / TMC
x- - - - - - - - - - - - - - - - - - -x
I, JENNIFER BALTAZAR JUNIO, Filipino, of legal age, single and residing at Daang Balite,
Barangay Lalaan I, Silang, Cavite, after having been duly sworn to in accordance with law do
177.I am the holder and possessor of a Philippine Passport duly issued by Department of
Foreign Affairs, Manila;
178.I usually kept my said passport inside the cabinet in our house for safekeeping;
179.Sometime in 2019, when I checked the same inside my cabinet, I discovered that my said
Passport was missing and despite all my diligent efforts exerted to locate the same but to no
avail;
person or entity;
may serve.
JENNIFER BALTAZAR JUNIO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 21st day of March, 2022
personally appeared JENNIFER BALTAZAR JUNIO with her Voter’s ID No. 5102-0056A-
F2886JBJ20000 issued by COMELEC Calintaan, Occidental Mindoro, presenting the above
Doc. No. ____;

Page No. ____; Atty. IRINEO A. ANARNA
Book No. ____; Notary Public for the Province of Cavite
Series of 2022.
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - -x
I, LOVELY DIAN COSTA UMALI, Filipino, of legal age, married and residing at Phase 3,
Barangay Santol, Silang, Cavite, after having been duly sworn to in accordance with law do hereby
184.Sometime in 2017, our family transferred and changed our residents from Tanza, Cavite to
Silang, Cavite and brought with us all our personal belongings and put all things inside a box
including my Philippine Passport for safekeeping. Unfortunately, while organizing our things
in our new house at Silang, Cavite, I noticed that one of the boxes containing my said
Passport and my other important documents were missing and despite all my diligent efforts
exerted to locate the same but to no avail;
person or entity;
may serve.
LOVELY DIAN COSTA UMALI

Affiant
2022 personally appeared LOVELY DIAN COSTA UMALI with her Voter’s ID No. 2118-0397B-
I1387LEC20000 issued by COMELEC Silang, Cavite, presenting the above affidavit who is
Doc. No. ____;

Page No. ____; ` Atty. IRINEO A. ANARNA
Series of 2022. Commission No. TG-20-009, valid until Dec. 31, 2022
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - -x
I, FRANCIS CASIN SERRANO, Filipino, of legal age, married and residing at 021 Barangay
Adlas, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
188.I am the holder and possessor of a Philippine Passport bearing passport number QQ
0607149 duly issued by Department of Foreign Affairs, Manila on 23 June 2005 and expires
on 23 June 2010;
189.I kept my said passport inside the drawer in our old house at Barangay Adlas, Silang,
Cavite for safekeeping;
190.Sometime in 2009, when I checked the same, I discovered that my Philippine Passport was
misplaced and despite all my diligent efforts exerted to locate the same but to no avail;
person or entity;
may serve.
FRANCIS CASIN SERRANO

Affiant
2022 personally appeared FRANCIS CASIN SERRANO with his Non-Professional Driver’s License
ID No. D18-19-019409 issued by LTO and valid until 2024/10/09, presenting the above affidavit
who is personally known to me or identified by me through competent evidence of identity as
defined by the National Rules as the person who signs the document and in my presence taken an
oath or affirmation before me as to such document. WITNESS MY HAND AND SEAL ON THE
Doc. No. ____;

Page No. ____; `
Book No. ____;
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - -x
I, WALDEN BUENDIA CABUYA, Filipino, of legal age, married and residing at Block 26, Lot
17, Buklod Bahayan, Barangay Tartaria, Silang, Cavite, after having been duly sworn to in
EC7746644 duly issued by Department of Foreign Affairs, Lucena on 18 May 2018 and
expires on 17 May 2021;
195.I securely place my said passport inside an envelope and kept inside our house in Block
26, Lot 17, Buklod Bahayan, Barangay Tartaria, Silang, Cavite for safekeeping;
196.On March 26, 2019, when I checked the same, I discovered that my envelope containing
my Philippine Passport was missing and despite all my diligent efforts exerted to locate the
shoulder bag containing my said passport but to no avail;
person or entity;
may serve.
WALDEN BUENDIA CABUYA

Affiant
2022 personally appeared WALDEN BUENDIA CABUYA with his Professional Driver’s License ID
No. D04-01-166463 issued by LTO, valid until 2023/07/14, presenting the above affidavit who is
Doc. No. ____;

Page No. ____; `
Book No. ____; Atty. IRINEO A. ANARNA
Series of 2022. Notary Public for the Province of Cavite
PTR No. 5498388 / 1-03-2022 / TMC

x- - - - - - - - - - - - - - - - - - -x
I, JULIET ALMAREZ VILLALUZ, Filipino, of legal age, married and residing at Lalaan 1 st,
Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose and say
that:
P2717721B duly issued by Department of Foreign Affairs, Manila on 05 August 2019 and
expires on 04 August 2029;
201.Sometimes in January 2022, I boarded on a passenger bus from Pasay City to Silang,
Cavite. I brought along with me my aforesaid passport which was in my shoulder bag at that
time. However, upon alighted at Silang, Cavite, I noticed that my shoulder bag containing
my Philippine Passport was missing and despite all my diligent efforts exerted to locate the
shoulder bag containing my said passport but to no avail;
person or entity;
may serve.
JULIET ALMAREZ VILLALUZ

Affiant
2022 personally appeared JULIET ALMAREZ VILLALUZ with her Police Clearance Card with
control number SMPS-M-002200 issued on March 04, 2022 and valid until July 04, 2022 by Silang
Cavite Police Station, presenting the above affidavit who is personally known to me or identified by
me through competent evidence of identity as defined by the National Rules as the person who
WRITTEN.
Doc. No. ____;

Page No. ____; ` Atty. IRINEO A. ANARNA
Series of 2022. Commission No. TG-20-009, valid until Dec. 31, 2022
PTR No. 5498388 / 1-03-2022 / TMC
x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, LUISA SHERYL LOSAURA CRUZ, Filipino, of legal age, single and 142 Purok 5,
Barangay Litlit, Silang, Cavite, after having been duly sworn to in accordance with law do hereby
P2778117A duly issued by Department of Foreign Affairs, Manila on 23 Apr 2017, valid until
22 Apr 2022, which I securely place inside an envelope for safekeeping;
206.Sometimes on April 2020, I went to Manila and brought with me my envelope containing my
said passport to look for a work abroad and after my transaction, I boarded on a passenger
bus from Manila and alighted to Silang, Cavite. However, upon reaching home, I noticed that
my Philippine Passport was missing and I believe that the same fell unnoticed from my
envelope and despite all my diligent efforts exerted to locate the said passport but to no avail;
person or entity;
may serve.
LUISA SHERYL LOSAURA CRUZ

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 19th day of February,
2022 personally appeared LUISA SHERYL LOSAURA CRUZ with her Voter’s ID No. 2118-0437B-
F2189LLC20000 issued by COMELEC Silang, Cavite, presenting the above affidavit who is
Doc. No. ____;

Page No. ____; `
Book No. ____;
Series of 2022.

Republic of the Philippines) Roll of Attorneys No. 32080
Silang, Cavite ) S.S. IBP No. 01666/ Lifetime Member
PTR No. 5498388 / 1-03-2022 / TMC
x- - - - - - - - - - - - - - - - - - -x MCLE No. VII ---- 0003161 / May 15, 2021 / valid until April 14, 2025
AFFIDAVIT OF LOSS
I, ROSELLE ATIENZA MONTALLANA, Filipino, of legal age, single and with permanent
address at Zone 1, Malasin, San Jose City, Nueva Ecija, after having been duly sworn to in
Foreign Affairs, Manila which I securely place inside an envelope for safekeeping;
211.On February 03, 2022, I boarded on a passenger bus from San Jose City, Nueva Ecija to
Silang, Cavite. However, upon alighted on the passenger bus at Silang, Cavite I noticed that
the envelope containing my Philippine Passport was missing and I believe that I left the
same inside the passenger bus and despite all my diligent efforts exerted to locate the said
passport but to no avail;
person or entity;
may serve.
ROSELLE ATIENZA MONTALLANA

Affiant
2022 personally appeared ROSELLE ATIENZA MONTALLANA with her SSS ID No. 10-0561632-
0, presenting the above affidavit who is personally known to me or identified by me through
Doc. No. ____;

Page No. ____; `
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, PRINCESS JOY SANTOS MAGAT, Filipino, of legal age, married and with permanent
address at Zone 3, Malasin, San Jose City, Nueva Ecija, after having been duly sworn to in
Foreign Affairs, Manila which I securely place inside an envelope for safekeeping;
216.On February 03, 2022, I boarded on a passenger bus from San Jose City, Nueva Ecija to
Silang, Cavite. However, upon alighted on the passenger bus at Silang, Cavite I noticed that
the envelope containing my Philippine Passport was missing and I believe that I left the
same inside the passenger bus and despite all my diligent efforts exerted to locate the said
person or entity;
may serve.
PRINCESS JOY SANTOS MAGAT

Affiant
2022 personally appeared PRINCESS JOY SANTOS MAGAT with her National ID No. 4906-9819-
Doc. No. ____;

Page No. ____; `
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, EVANGELINE ESPIRITU NOVELO, Filipino, of legal age, married and residing at 142
Barangay Litlit, Silang, Cavite, after having been duly sworn to in accordance with law do hereby
221.On January 28, 2022, I went to Talisay, Batangas and brought with me my said passport for
identification and placed it inside my bag for safekeeping. However, upon reaching home in
the evening of the same day, I noticed that my passport was missing and I believe that the
same fell unnoticed from my bag and despite all my diligent efforts exerted to locate the said
person or entity;
may serve.
EVANGELINE ESPIRITU NOVELO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 31st day of January,
2022 personally appeared EVANGELINE ESPIRITU NOVELO with her Voter’s ID No. 2118-
0268A-H1580EEN20000 issued by COMELEC Silang, Cavite, presenting the above affidavit who
Doc. No. ____;

Page No. ____; `
Book No. ____;
Series of 2022.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, NESTOR ROJO CABUSAO, Filipino, of legal age, married and residing at C-1
Charlestone Terrace Buenos Aires St., BF Homes, Las Piñas City, after having been duly sworn to
P0730813A issued on 24 Oct. 2016 by PE Riyadh and valid until 23 Oct. 2021;
226.I usually placed my said passport inside my sling bag for safekeeping;
227.On October 27, 2021, when I checked my said passport in my sling bag, I noticed that my
passport was missing and I believe that the same fell unnoticed from my sling bag and
despite all my diligent efforts exerted to locate the said passport but to no avail;
person or entity;
may serve.
NESTOR ROJO CABUSAO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 27th day of December,
2021 personally appeared NESTOR ROJO CABUSAO with his Professional Driver’s License ID
No. N26-09-006753 issued by LTO and valid until 2023/10/27, presenting the above affidavit who
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2021.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, LENNY GABIOLA BRIOSO, Filipino, of legal age, widow and residing at Barangay Lalaan
1st, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose and
say that:
232.I securely placed my said passport inside my brown envelope in my cabinet at my house in
my address above-mentioned for safekeeping;
233.Sometimes in September 2016, when I checked my brown envelope in my cabinet, I

noticed that my brown envelope containing my passport was missing and despite all my
diligent efforts exerted to locate the said passport but to no avail;
person or entity;
may serve.
LENNY GABIOLA BRIOSO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 6th day of December,
2021 personally appeared LENNY GABIOLA BRIOSO with her Voter’s ID No. 2102-0064A-
B0586LGB20000 issued by COMELEC Amadeo, Cavite, presenting the above affidavit who is
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2021.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, GELYN RUADO AGUILAR, Filipino, of legal age, married and residing at Sitio Bayungan,
Barangay Kaong, Silang, Cavite, after having been duly sworn to in accordance with law do hereby
238.I securely placed my said passport inside my plastic envelope for safekeeping;
239.On October 25, 2021, I boarded on a passenger bus from Novaliches, Quezon City to
Silang, Cavite. However, upon alighted at Silang, Cavite, I noticed that my plastic envelope
containing my said passport was missing and despite all my diligent efforts exerted to locate the
said passport but to no avail;
person or entity;
may serve.
GELYN RUADO AGUILAR

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 29th day of November,
2021 personally appeared GELYN RUADO AGUILAR with her UMID CRN-0033-7741794-1,
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2021.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, KURT ROMEL BAS SANTOS, Filipino, of legal age, single and residing at Block 2, Lot 8,
Lemillia, Barangay Biga 1, Silang, Cavite, after having been duly sworn to in accordance with law
243.I am the holder and possessor of a Philippine Passport bearing number P3086898B duly
issued by Department of Foreign Affairs (DFA), Manila on 06 September 2019 and valid
until 05 September 2024;
244.I securely placed my said passport inside my bag for safekeeping;
245.Sometimes on April 2021, I went to Bicol for vacation and brought with me my said
passport as my valid identification card. However, upon reaching my place of destination, I
noticed that my said passport was missing and I believe that the same fell unnoticed from
my bag while I was at my residence address in Silang, Cavite and despite all my diligent
efforts exerted to locate the said passport but to no avail;
person or entity;
may serve.
KURT ROMEL BAS SANTOS

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 26th day of November,
2021 personally appeared KURT ROMEL BAS SANTOS with his Police Clearance with Control
No. SMPS-M-007031 issued on November 26, 2021 by PNP Silang, Cavite, presenting the above
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2021.
x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, EDUARDO CUNANAN BALDONADO, Filipino, of legal age, married and presently

residing at Barangay Lalaan 1st, Silang, Cavite, after having been duly sworn to in accordance with
Foreign Affairs (DFA), NCR South;
251.However, today September 29, 2021, my bag containing my said passport went missing
and nowhere to be found and despite all my diligent efforts exerted to locate the said passport but
to no avail;
person or entity;
may serve.
EDUARDO CUNANAN BALDONADO

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 29th day of September,
2021 personally appeared EDUARDO CUNANAN BALDONADO with his Professional Driver’s
License ID No. N04-94-318204 issued by LTO and valid until 2022/03/21, presenting the above
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2021.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, AILYN REBLORA MUYNA, Filipino, of legal age, married and presently residing at
Barangay Sabutan, Silang, Cavite, after having been duly sworn to in accordance with law do
255.I am the holder and possessor of a Philippine passport bearing passport number
P4712190A issued on 13 October 2017 by Department of Foreign Affairs (DFA), Legazpi
and valid until 12 October 2022;
257.However, on August 15, 2021, my said passport fell unnoticed from my bag and despite all
my diligent efforts exerted to locate the said passport but to no avail;
person or entity;
may serve.
AILYN REBLORA MUYNA

Affiant
2021 personally appeared AILYN REBLORA MUYNA with her Voter’s ID No. 0502-0013A-
B0286ARM20000 issued by COMELEC Camalig, Albay, presenting the above affidavit who is
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2021.

x- - - - - - - - - - - - - - - - - - -x
AFFIDAVIT OF LOSS
I, ANALYN AMODENTE EMELO, Filipino, of legal age, married and residing at Ravelo
Street, Barangay Sabutan, Silang, Cavite, after having been duly sworn to in accordance with law
261.I am the holder and possessor of a Philippine passport bearing number EB8062493 issued
on 08 May 2013d duly issued to me by Department of Foreign Affairs (DFA), Manila and
valid until 07 May 2018;
263.However, sometimes in year 2017, my said passport fell unnoticed from my bag and
despite all my diligent efforts exerted to locate the said passport but to no avail;
person or entity;
may serve.
ANALYN AMODENTE EMELO

Affiant
2021 personally appeared ANALYN AMODENTE EMELO with her Philhealth ID No. 03-
Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, MARICEL RODRIGUEZ CAO, Filipino, of legal age, single and with residence address at
Barangay Pulong Bunga, Silang, Cavite, after being duly sworn to in accordance to law do hereby
declare that:

P8736854A issued on September 13, 2018 by Department of Foreign Affairs (DFA), Manila and
valid until September 12, 2028;
1. I securely placed my said passport inside my plastic envelope together with my

other documents for safekeeping;
2. On June 29, 2021, I boarded on a passenger bus from Manila to Silang, Cavite.
However, upon reaching home, I noticed that my plastic envelope containing my said passport was
missing and despite all my diligent efforts exerted to locate my passport but to no avail;
transferred, donated, or given as a collateral for any debt or obligation to or in favor of any person
or entity;
may no longer be used for travel or other purposes. As such, in case the said passport is found or
5. I executed this affidavit to attest to the truth and veracity of the foregoing statements
and for all legal intents and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto signed below.
MARICEL RODRIGUEZ CAO

Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 12 th day of August, 2021
personally appeared MARICEL RODRIGUEZ CAO with her Philhealth ID No. 02-025907789-4,
presenting an Affidavit of Loss and is attested to be personally identified by me through competent
evidence of identity as defined by the Rules on Notarial Practice of 2004, and she acknowledged to
me that she voluntarily executed and signed the same. WITNESS MY HAND AND SEAL ON THE
PLACE AND DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, RIALYN DURAN SUBRIO, Filipino, of legal age, single and with residence address at
Purok 1, Barangay Lumil, Silang, Cavite, after being duly sworn to in accordance to law do hereby
declare that:

P0935719A issued on November 17, 2016 by Department of Foreign Affairs (DFA), Manila and
valid until November 16, 2021;
7. I securely placed my said passport inside my bag for safekeeping;
8. On July 27, 2021, I went to Silang Town Proper, Silang, Cavite and brought with me
my said passport for my identification. However, after I went to Silang town proper I boarded on a
passenger jeepney on my way home and upon checking my passport inside my bag, I noticed that
my said passport was missing and despite all my diligent efforts exerted to locate my passport but
to no avail;
or entity;
MARIAH DJELSY AVILA GUEVARRA

Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 30 th day of July, 2021
personally appeared MARIAH DJELSY AVILA GUEVARRA with her PRC License ID No. 0881556
issued by PRC and valid until 04/12/2022, presenting an Affidavit of Loss and is attested to be
personally identified by me through competent evidence of identity as defined by the Rules on
Notarial Practice of 2004, and she acknowledged to me that she voluntarily executed and signed
the same. WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE
WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, MARIAH DJELSY AVILA GUEVARRA, Filipino, of legal age, single and with residence
address at Block 7 Lot 3 Tierra Nevada Phase 4, Barangay San Francisco, General Trias City,
Cavite, after being duly sworn to in accordance to law do hereby declare that:
P0935719A issued on November 17, 2016 by Department of Foreign Affairs (DFA), Manila and
valid until November 16, 2021;
14. On July 27, 2021, I went to Silang Town Proper, Silang, Cavite and brought with me
my said passport for my identification. However, after I went to Silang town proper I boarded on a
passenger jeepney on my way home and upon checking my passport inside my bag, I noticed that
my said passport was missing and despite all my diligent efforts exerted to locate my passport but
to no avail;
or entity;
MARIAH DJELSY AVILA GUEVARRA

Affiant
personally appeared MARIAH DJELSY AVILA GUEVARRA with her PRC License ID No. 0881556
issued by PRC and valid until 04/12/2022, presenting an Affidavit of Loss and is attested to be
WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, JURALYN CABUNOC CONDO, Filipino, of legal age, single and with residence address
at Barangay Lalaan I, Silang, Cavite, after being duly sworn to in accordance to law do hereby
declare that:
P6610221A issued on April 02, 2018 by Department of Foreign Affairs (DFA), Cotabato and valid
until April 01, 2028;
20. On June 10, 2021, I boarded on a passenger jeepney going to Silang Town Proper,
Silang, Cavite. However, upon alighted, I noticed that my said passport was missing in my bag and
despite all my diligent efforts exerted to locate my passport but all efforts proved futile and to no
avail;
or entity;
JURALYN CABUNOC CONDO

Affiant
personally appeared JURALYN CABUNOC CONDO with her Brgy. ID No. BL-097220014-20-006
issued by Brgy. Bongon, Sirawai, Zamboanga Del Norte and valid until 12-31-2022, presenting an
Affidavit of Loss and is attested to be personally identified by me through competent evidence of
identity as defined by the Rules on Notarial Practice of 2004, and she acknowledged to me that she
voluntarily executed and signed the same. WITNESS MY HAND AND SEAL ON THE PLACE AND
DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, DAYYAM OTOH SARIUL, Filipino, of legal age, single and with residence address at
Barangay Lalaan I, Silang, Cavite, after being duly sworn to in accordance to law do hereby declare
that:
P6506231B issued on March 17, 2021 by Department of Foreign Affairs (DFA), Zamboanga and
valid until March 16, 2031;
avail;
or entity;
DAYYAM OTOH SARIUL

Affiant
personally appeared DAYYAM OTOH SARIUL with her Philhealth ID No. 14-025262144-6,
presenting an Affidavit of Loss and is attested to be personally identified by me through competent
evidence of identity as defined by the Rules on Notarial Practice of 2004, and she acknowledged to
me that she voluntarily executed and signed the same. WITNESS MY HAND AND SEAL ON THE
PLACE AND DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, WAHIDA MANOT MAMASABALA, Filipino, of legal age, single and with permanent
address at Barangay Maindang, Lutayan Proper Lutayan, Sultan Kudarat, after being duly sworn to
in accordance to law do hereby declare that:
P0274655A issued on September 17, 2016 by Department of Foreign Affairs (DFA), General
Santos and valid until September 16, 2021;
avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 6th day of July, 2021.
WAHIDA MANOT MAMASABALA

Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 6th day of July, 2021
personally appeared WAHIDA MANOT MAMASABALA with her TIN ID No. 477-633-277-000
issued on 01-13-2016 by BIR, presenting an AFFIDAVIT OF LOSS and is attested to be personally
identified by me through competent evidence of identity as defined by the Rules on Notarial
Practice of 2004, and she acknowledged to me that she voluntarily executed and signed the same.
WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, MONA DADING GAPOL, Filipino, of legal age, single and with permanent address at
Barangay Pamalian, Pikit, North Cotabato, after being duly sworn to in accordance to law do
hereby declare that:
P0798681A issued on November 11, 2016 by Department of Foreign Affairs (DFA), General
Santos and valid until November 10, 2021;
avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 6th day of July, 2021.
MONA DADING GAPOL

Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 6th day of July, 2021
personally appeared MONA DADING GAPOL with her TIN ID No. 669-698-741-000 issued on 08-
04-2017 by BIR, presenting an AFFIDAVIT OF LOSS and is attested to be personally identified by
me through competent evidence of identity as defined by the Rules on Notarial Practice of 2004,
and she acknowledged to me that she voluntarily executed and signed the same. WITNESS MY
HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, MA. VIOLETA P. BILLONES, Filipino, of legal age, married and residing at 018 Barangay
Munting Ilog, Silang, Cavite, after being duly sworn to in accordance to law do hereby declare that:
42. I am the holder and possessor of a Philippine Passport bearing issued by

44. On October 17, 2005, my bag including my said passport was stolen by unidentified
culprit and despite all my diligent efforts exerted to locate my passport but all efforts proved futile
and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 2nd day of July, 2021.
MA. VIOLETA P. BILLONES

Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 2 nd day of July, 2021
personally appeared MA. VIOLETA P. BILLONES with her Senior ID No. 002336 issued on 8-19-19
by OSCA City of Manila, presenting an AFFIDAVIT OF LOSS and is attested to be personally
identified by me through competent evidence of identity as defined by the Rules on Notarial
Practice of 2004, and she acknowledged to me that she voluntarily executed and signed the same.
WITNESS MY HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, JENELYN OINTINA LIBRIA, Filipino, of legal age, married and residing at Barangay
Tartaria, Silang, Cavite, after being duly sworn to in accordance to law do hereby declare that:
48. I am the holder and possessor of a Philippine Passport bearing issued by

Department of Foreign Affairs (DFA), Pampanga;
49. I securely placed my said passport inside my brown envelope together with my other
documents for safekeeping;
50. Sometimes in April 2021, my brown envelope including my said passport went
missing and nowhere to be found and despite all my diligent efforts exerted to locate my passport
but all efforts proved futile and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 23rd day of June, 2021.
JENELYN OINTINA LIBRIA

Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 23 rd day of June, 2021
personally appeared JENELYN OINTINA LIBRIA with her TIN ID No. 421-746-221-000 issued on
02/23/2021 by BIR, presenting an AFFIDAVIT OF LOSS and is attested to be personally identified
by me through competent evidence of identity as defined by the Rules on Notarial Practice of 2004,
and she acknowledged to me that she voluntarily executed and signed the same. WITNESS MY
HAND AND SEAL ON THE PLACE AND DATE FIRST ABOVE WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, EMMALYN TAGARO YAMOAY, Filipino, of legal age, single and residing at Blk 11, Lot 7,
Sikap Ville Barangay Sabutan, Silang, Cavite, after being duly sworn to in accordance to law do
hereby declare that:
XX3398032 issued by Department of Foreign Affairs (DFA), Manila;
55. I securely placed my said passport inside my envelope together with my other
documents for safekeeping;
56. Sometimes in year 2015, I boarded on a passenger van in Manila and alighted in
Silang, Cavite. Unfortunately, upon reaching home I discovered that my envelope including my said
passport was missing and despite all my diligent efforts exerted to locate my passport but all efforts
proved futile and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 17th day of May, 2021.
EMMALYN TAGARO YAMOAY
Affiant
BEFORE ME, a Notary Public for the Province of Cavite, this 17 th day of May, 2021
personally appeared EMMALYN TAGARO YAMOAY with her NBI ID No. Y500BEBN97-
RD884758, valid until May 10, 2022, presenting an AFFIDAVIT OF LOSS and is attested to be
WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, DIVINA BUKLATIN BELEN, Filipino, of legal age, married and residing at Barangay
Batas, Silang, Cavite, after being duly sworn to in accordance to law do hereby declare that:
60. I am the holder and possessor of a Philippine Passport issued by Department of

62. Sometimes in October 2020, I discovered that my said passport was missing and I
believe that the same fell unnoticed from my bag and despite all my diligent efforts exerted to
locate my passport but all efforts proved futile and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 27th day of April, 2021.
DIVINA BUKLATIN BELEN

Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 27th
day of April 2021, personally appeared DIVINA BUKLATIN BELEN with her TIN ID No. 718-600-
738-000 issued on 03-23-2018 by BIR, presenting the above Affidavit who is personally known to
me or identified by me through competent evidence of identity as defined by the Notarial Rules as
WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, APRILYN LOGMAO ORFALAS, Filipino, of legal age, single and residing at Barangay
Cabangaan, Silang, Cavite, after being duly sworn to in accordance to law do hereby declare that:
66. I am the holder and possessor of a Philippine Passport issued by Department of

Foreign Affairs (DFA), Lucena City;
67. I securely placed my said passport inside the cabinet in our house for safekeeping;
68. Sometimes in year 2019, I noticed that my said passport was missing and despite all
my diligent efforts exerted to locate my passport but all efforts proved futile and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 12th day of April, 2021.
APRILYN LOGMAO ORFALAS

Affiant
day of April 2021, appears the person of APRILYN LOGMAO ORFALAS with her Philhealth ID No.
08-025701110-4, presenting the above Affidavit who is personally known to me or identified by me
through competent evidence of identity as defined by the Notarial Rules as the person who signs
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, MARY JOY VALENZUELA MOJADO, Filipino, of legal age, married and residing at
Benitez Compound, Brgy. Lalaan 1st, Silang, Cavite, after being duly sworn to in accordance to law
do hereby declare that:
72. I am the holder and possessor of a Philippine Passport bearing number P0364651A
issued on September 23, 2016 by Department of Foreign Affairs (DFA), Iloilo and valid until
September 22, 2021;
74. On December 15, 2019, I went to Palawan Pawnshop Pera Padala at the town
proper of Silang, Cavite and presented my said Passport for my identification so that I could get the
money which was sent to me. Unfortunately, upon reaching home, I noticed that my said passport
was missing and despite all my diligent efforts exerted to locate my passport but all efforts proved
futile and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 29th day of March, 2021.
MARY JOY VALENZUELA MOJADO

Affiant
day of March 2021, appears the person of MARY JOY VALENZUELA MOJADO with her Voter’s ID
No. 1914-0086A-A2683MVM20000 issued by COMELEC Roxas City, Capiz, presenting the above
Affidavit who is personally known to me or identified by me through competent evidence of identity
as defined by the Notarial Rules as the person who signs the document and in my presence taken
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, SHIELA BRANA FERTES, Filipino, of legal age, single and presently residing at P.
Montoya Street Barangay San Vicente 2, Silang, Cavite, after being duly sworn to in accordance to
law do hereby declare that:
78. I am the holder and possessor of a Philippine Passport duly issued to me by

79. I usually placed my said passport inside my bag for safekeeping;
80. Sometime in year 2015, I discovered that my said passport went missing and
nowhere to be found and despite all my diligent efforts exerted to locate my passport but all efforts
proved futile and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 26th day of March, 2021.
SHIELA BRANA FERTES

Affiant
day of March, 2021, appears the person of SHIELA BRANA FERTES with her UMID CRN-0033-
7914038-4, presenting the above Affidavit of Loss who is personally known to me or identified by
me through competent evidence of identity as defined by the Notarial Rules as the person who
WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2021.

x----------------------------------x
AFFIDAVIT OF LOSS
I, SAMANTHA FLOR AZUELO DOROPAN, Filipino, of legal age, single and presently
residing at Baguio Heights Barangay Adlas, Silang, Cavite, after being duly sworn to in accordance
to law do hereby declare that:
84. I am the holder and possessor of a Philippine Passport bearing number P7592827A
issued on June 20, 2018 by Department of Foreign Affairs (DFA), Manila and valid until June 19,
2028;
85. I securely placed my said passport inside my cabinet together with my other
documents at our house located at Barangay Lalaan I, Silang, Cavite for safekeeping;
86. Sometime in July 2019, upon changing of residency from Barangay Lalaan I, Silang,
Cavite to Baguio Heights Barangay Adlas, Silang, Cavite, I noticed that my said passport was
missing and despite all my diligent efforts exerted to locate my passport but all efforts proved futile
and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 16 th day of December,

2020.
SAMANTHA FLOR AZUELO DOROPAN

Affiant
day of December 2020, appears the person of SAMANTHA FLOR AZUELO DOROPAN with her
UMID CRN-0111-5699515-2, presenting the above Affidavit who is personally known to me or
identified by me through competent evidence of identity as defined by the Notarial Rules as the
WRITTEN.
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2020.

x----------------------------------x
AFFIDAVIT OF LOSS
I, NURHIDA ISDARI ABDUNNASIR, Filipino, of legal age, single and presently residing at
Barangay Batas, Silang, Cavite, after being duly sworn to in accordance to law do hereby declare
that:
90. I am the holder and possessor of a Philippine Passport duly issued by Department
of Foreign Affairs (DFA), Zamboanga City;
91. I securely placed my said passport in my cabinet at my house in Jolo, Sulu for
safekeeping;
92. Sometime in April 2018, our house got burned including my said passport and
despite all my diligent efforts exerted to save my passport but all efforts proved futile and to no
avail;
or entity;

2020.
NURHIDA ISDARI ABDUNNASIR

Affiant
day of December 2020, appears the person of NURHIDA ISDARI ABDUNNASIR with her Postal ID
No. PRN N49200366211 P issued by Post Office Silang, Cavite and valid until December 01, 2023,
presenting the above Affidavit who is personally known to me or identified by me through
competent evidence of identity as defined by the Notarial Rules as the person who signs the
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2020.

x----------------------------------x
AFFIDAVIT OF LOSS
I, WINDY CLAIRE MANLUZA DELA CRUZ, Filipino, of legal age, single and residing at
Barangay San Vicente I, Silang, Cavite, after being duly sworn to in accordance to law do hereby
declare that:
96. I am a holder of a Philippine Passport bearing number XX4764375 issued to me by

the Philippine Embassy Brunei on October 15, 2009 and got expired on October 14, 2014;
97. I usually place my said passport inside my bag for safekeeping;
98. On November 23, 2020, I went to Manila to look for a work abroad and brought with
me my said passport. Unfortunately, upon reaching home, I noticed that my said passport was
missing and I believe that the same fell unnoticed from my bag and despite all my diligent efforts to
recover my passport but all efforts proved futile and to no avail;
or entity;

2020.
WINDY CLAIRE MANLUZA DELA CRUZ

Affiant
day of December 2020, appears the person of WINDY CLAIRE MANLUZA DELA CRUZ with her
Postal ID No. PRN D73170097885 P issued by Post Office Silang, Cavite and valid until November
26, 2023, presenting the above Affidavit who is personally known to me or identified by me through
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2020.

x----------------------------------x
AFFIDAVIT OF LOSS
I, RONENA TALAMOR BARRIOS, Filipino, of legal age, single and residing at 116 E
Barangay Lucsuhin, Silang, Cavite, after being duly sworn to in accordance to law do hereby
declare that:
102. I am a holder of a Philippine Passport bearing number P4894006B issued to me by

the Department of Foreign Affairs, Manila on February 20, 2020 and valid until February 19, 2030;
103. On June 26, 2020, my said Philippine Passport went missing and nowhere to be
found and despite all my diligent efforts to recover my passport but all efforts proved futile and to no
avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 6th day of October, 2020.
RONENA TALAMOR BARRIOS
Affiant
day of October 2020, appears the person of RONENA TALAMOR BARRIOS with her Postal ID No.
PRN D94200108120 P issued by Post Office Samal, Davao Del Norte and valid until February 14,
2023, presenting the above Affidavit who is personally known to me or identified by me through
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2020.

x----------------------------------x
AFFIDAVIT OF LOSS
I, NEMENCIO M. QUINTANILLA, Filipino, of legal age, married and residing at 49 Street

Metrogate Subdivision San Agustin I, Dasmariñas, Cavite, after being duly sworn to in accordance
to law do hereby declare that:
107. I am a holder of a Philippine Passport issued to me by the Department of Foreign

Affairs, Manila;
108. Sometime in year 1977, my said Philippine Passport went missing and nowhere to
be found and despite all my diligent efforts to recover my passport but all efforts proved futile
and to no avail;
or entity;
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 4th day of February, 2020.
NEMENCIO M. QUINTANILLA
Affiant
day of February 2020, appears the person of NEMENCIO M. QUINTANILLA with his Senior ID
No. 2011/4521 issued on 01-10-11 by OSCA Imus City, Cavite, presenting the above Affidavit who
the Notarial Rules as the person who signs the document and in my presence taken an oath or
Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2020.

x----------------------------------x
I, EVANGELINE MARQUINA RUIZ, Filipino, of legal age, married and residing at Brgy.
Batas, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
1. I am a holder and possessor of a passport duly issued to me by the Department of

Foreign Affairs, Manila
2. Sometime in August 2015, I brought along with me my passport in Baclaran, Pasay City,
at that moment my said was kept in a brown envelope. However, I was on my way, I
discovered that my envelope containing my passport and other important documents
fell unnoticed and despite diligent searched but in vain;
transferred, donated, or given as a collateral for any debt or obligation to or in favor of
any person or entity;
4. I further understand that said passport will be immediately deemed cancelled and may
no longer be used for travel or other purposes. As such, in case the said passport is
found or retrieved undersigned will immediately surrender it to the Department of
Foreign Affairs;
5. I executed this affidavit to attest to the truth and veracity of the foregoing statements to
request proper authorities concerned to grant me a new passport in lieu of the lost one
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 15 th day of October, 2019.
EVANGELINE MARQUINA RUIZ

Affiant
October, 2019, appears the person of: EVANGELINE MARQUINA RUIZ with her SSS ID Number
33-3930244-7, presenting the above affidavit who is personally known to me or identified by me
WITNESS MY HAND AND SEAL ON THE DATE AND PLACE FIRST ABOVE-WRITTEN.
Doc. No. ______

Page No. ______
Book No. ______
Series of 2019

x--------------------------------x
I, MIKA FORONDA, Filipino, of legal age, single and residing at Santol, Silang, Cavite ,
after having been duly sworn to in accordance with law do hereby depose and say that:
1. I am the lawful holder of Philippine Passport issued by Department of Foreign Affairs

(DFA) Manila;
2. My said passport is in a folder and kept it in a cabinet. However, during the time when a
strong typhoon Ondoy strike I and family were formerly residing at Parañaque, City;
3. During the said calamity, our house in Parañaque City was washed away by said
typhoon including all our important documents one of which is my passport and despite all my
diligent efforts to retrieve it but my efforts prove futile hence my passport may now be deemed lost
and irretrievable;
or entity;
no longer be used for travel or other purposes. As such, in case the said passport is found or
6. I am executing this affidavit to attest to the truth and veracity of the foregoing acts and for
whatever legal purposes it may serve under the law.
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 3rd day of May, 2017.
MIKA FORONDA
Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 3 rd day of May,
2017 appears the person of: MIKA FORONDA with her Postal Identity Card Number
D73170157665 issued by Silang, Cavite Post Office and valid until 06 Mar 20, presenting the
identity as defined by the Notarial Rules as the person who signs the document and in my
SEAL ON THE DATE AND PLACE FIRST ABOVE-WRITTEN.
Doc. No. _______

Page No. _______
Book No. _______
Series of 2017

x--------------------------------x
I, ELIZABETH B. DE LOS REYES, Filipino, of legal age, single and residing at Blk 17 Lot 18
Brgy. Tartaria, Silang, Cavite, after having been duly sworn to in accordance with law do hereby

(DFA) with passport number XX22594341 issued to me on ____________ and expires on October
10, 2013.
2. On June 15, 2016, I noted that the said passport was missing;
3. To my knowledge, my passport was lost when I went to Hongkong;
4. I exerted diligent efforts to locate the same but my effort proves futile hence my passport
may now be deemed lost and irretrievable;
5. The said passport has not been encumbered, sold pledged, assigned, alienated,
or entity;
6. I understand that my declaration of the abovementioned passport as lost shall be

construed as satisfactory proof that the passport was lost, in compliance with the Section 15 of
R.A. 8239 or the Philippine Passport Act of 1996;
no longer be used for travel or other purposes. As such, in case the said passport is found or
8. I am executing this affidavit to attest to the truth and veracity of the foregoing facts and
for whatever legal purposes it may serve under the law.
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 24 th day of January, 2017.
ELIZABETH B. DE LOS REYES

Affiant
January, 2017 appears the person of: ELIZABETH B. DE LOS REYES with her UMID No. CRN-
0111-385972-4, presenting the above affidavit who is personally known to me or identified by me
WITNESS MY HAND AND SEAL ON THE DATE AND PLACE FIRST ABOVE-WRITTEN.
Doc. No ______; Atty. IRINEO A. ANARNA

Page No. ______; Notary Public
Book No. 232; No. 4 Madlansacay St., Poblacion 2
Series of 2017 Silang, Cavite
Until December 31, 2018
PTR No. 8528928/ 1-03-2017/ TMC
Commission No. TG-16-024

x--------------------------------x
I, MARGIE A. SACRO, Filipino, of legal age, married and residing at Blk 36 Lot 15 Banaba,
Bulihan Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:

(DFA) with passport number P1050881A issued to me on 01 Dec 2016 and expires on 30 Nov
2021.
2. Last January 5, 2017, I boarded on a passenger bus and I brought along with me the
said passport in Manila. At that moment, it was kept in a brown envelope. However, when I
alighted in the said bus and reached my destination, I discovered that my brown envelope was
missing and presumed left it in the bus when I alighted from it;
3. I exerted diligent efforts to locate my said passport bu up to this moment, I falied to

locate it;
4. Likewise, I never entrusted or submitted my passport in any person or entity or agency;
request proper authorities concerned to grant me a new passport in lieu of the lost one and for all
legal intents and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 19 th day of January, 2017.
MARGIE A. SACRO
Affiant
January, 2017 appears the person of: MARGIE A. SACRO with her Postal Identity Card number
D73160542498 issued by Silang, Cavite Post Office and valid until 04 Nov 19, presenting the

PTR No. 8528928/ 1-03-2017/ TMC

x------------------------------------x
AFFIDAVIT OF LOSS
I, MARCELINA RAMOS ATIS, Filipino, of legal age, married and residing at Tibag, Tarlac
City, after having been duly sworn to in accordance with law do hereby depose and say that:
1. I am the holder and possessor of a Philippine passport number EC1713682 duly issued to
me Department of Foreign Affairs, Bacolod City on July 24, 2014 and valid until July 23,
2019;
2. Last December 9, 2015 at around 6:00 o’çlock in the morning I left Tibag, Tarlac City, I
brought along with me my passport which was in a pouch bag. I arrived in Quezon City
( bus terminal) almost 11:00 o’çlock in the morning, then, I boarded on a passenger bus
going to Balibago, Sta. Rosa City Laguna, from there I alighted in the said bus and boarded
on a passenger jeep going to my brother’s residence in Pasong Langka, Silang, Cavite;
3. However, upon reaching Pasong Langka, Silang, Cavite, I discovered that my pouch bag
was missing in my bag including my above-mentioned passport;
4. Despite all diligent efforts exerted to locate my passport but to no avail;
request proper authorities concerned to grant me a new passport and for all legal intents
and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto signed below this 10th day of December, 2015 at
Silang, Cavite.
MARCELINA RAMOS ATIS

Affiant
December, 2015 appears the person of MARCELINA RAMOS ATIS with her SSS ID Number 06-
1401509-6, who is personally known to me or identified by me through competent evidence of

PTR No. 8528928/ 1-03-2017/ TMC

x----------------------------- -----x
AFFIDAVIT OF LOSS
I, BEVERLY M. MOJICA, Filipino, of legal age, single and residing at Brgy. Malaking
Tatiao, Silang, Cavite, after having been duly sworn to in accordance with law hereby depose and
say that:
1. I am a holder and possessor of passport with number EB5699519 duly issued to me by

Department of Foreign Affairs, Manila;
2. I usually place the said passport inside my bag for safekeeping;
3. However, on May 15, 2015, the said passport got lost and despite diligent efforts exerted
to locate my above-mentioned passport but to no avail;
4. I executed this affidavit to attest to the truth and veracity of the foregoing statements to
request proper authorities concerned to grant me a new passport in lieu of the lost one and for
all legal intents and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 28 th day of September,

2015.
BEVERLY M. MOJICA
Affiant
BEFORE ME, a Notary Public for and in the Province of Cavite, this 28 TH day of
September, 2015, appears the person of: BEVERLY M. MOJICA with her community tax
certificate number 11792717 issued at Silang, Cavite issued on 06-08-2015, presenting the above
Affidavit who is personally known to me or identified by me through competent evidence of

PTR No. 8528928/ 1-03-2017/ TMC

x-------------------------------------x
AFFIDAVIT OF LOSS
I, SHELLA BELEN JOSE, Filipino, of legal age, married and residing at #103 Barangay
Batas, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
1. I am a holder and possessor of a Passport issued to me by the Department of

2. The said passport was issued to me when I was still single and the name indicated
herein is my maiden name which is SHELLA LUDRIN BELEN;
3. On November 2010, I brought with me my said passport going to De La Salle

University Medical Center, Dasmariñas, Cavite;
4. When I am on my way going to the said hospital, I placed my travelling bag in the
jeepney flooring, however, I did not noticed that it was opened by a snatcher and
the small bag I placed inside with my passport was stolen;
5. I executed this affidavit to attest to the truth and veracity of the foregoing
statements, to request the Department of Foreign Affairs to grant me a new
passport for the reason above-mentioned and for all legal intents and purposes this
may serve.
IN WITNESS WHEREOF, I have hereunto signed Affidavit, this 9 th day of June, 2015 here
at Silang, Cavite.
SHELLA BELEN JOSE

Affiant
BEFORE ME, appears the person of SHELLA BELEN JOSE with her TIN ID bearing no.
459-661-287-000 issued on 11-06-14 issued by Bureau of Internal Revenue, presenting the above
Affidavit who is personally known to me or identified by me through competent evidence of identity
as defined by the Notarial Rules as the person who signs the document and in my presence taken
an oath or affirmation before me as to such document. WITNESS MY HAND AND SEAL THIS 9th
day of June, 2015.
Doc. No ______;
Page No. ______;
Book No. 201;
Series of 2015.
x-------------------------------------x
AFFIDAVIT OF MUTILATION
I, JONJON R. TOLEDO, Filipino, of legal age, married and residing at Brgy. Malabag,
Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose and say
that:
5. I am a holder and possessor of a passport issued by the Department of Foreign

Affairs, Manila bearing passport no. EB2979811 issued on July 9, 2011 and will expires
on July 8, 2016;
6. I securely placed my said passport in my cabinet for safekeeping;
7. However, recently, when I checked the same, I noticed that my said passport was
damaged by termites;
8. I executed this affidavit to attest to the truth and veracity of the foregoing statements, to
request the Department of Foreign Affairs to grant me a new passport and for all legal
intents and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto signed this 15 th day of January, 2014 in Silang,
Cavite.
JONJON R. TOLEDO
Affiant
BEFORE ME, appears the person of JONJON R. TOLEDO with his Professional
Driver’s License bearing no. D18-03-002817, expires on 06-11-2015, issued by LTO Tagaytay City,
presenting the above Affidavit who is personally known to me or identified by me through a
competent evidence of identity as defined by the Notarial Rules as the same person who signs the
document in my presence and taken an oath or affirmation before me as to such document.
WITNESS MY HAND AND SEAL THIS 15th day of January 2014 in Silang, Cavite.
Doc. No ____; Atty. IRINEO A. ANARNA

Page No. ____; Notary Public for the Province of Cavite
Book No. 182; Until December 31, 2014
PTR No. 4529884/ 1-02-2014/ TMC
x-------------------------------------x
AFFIDAVIT
I, ARMANDO M. MEDINA, Filipino, of legal age, married and residing at San Vicente II,
By-pass, Silang, Cavite, after having been duly sworn to in accordance with law do hereby depose
and say that:
1. I have been employed at White Industries Singapore PTE LTD with business address at
35 New Jalan Sam Kongsi, Off Tampines Road, Singapore 1852 Paya Lebar P.O. Box
120 Singapore 9154 from June 26, 1984 until July 24, 1986;
2. I and my nephew Nicanor B. Flores with passport no. D 023943 worked together in the
said company;
3. However, the certification issued by our former employer together with my passport
got lost;
IN WITNESS WHEREOF, I have hereunto signed this 19 th day of July, 2013 in Silang,
Cavite.
ARMANDO M. MEDINA
Affiant
BEFORE ME, appears the person of ARMANDO M. MEDINA, with his CTC No. 23420363,
issued on 07-19-13 issued at Silang, Cavite, presenting the above Affidavit who is personally
known to me or identified by me through a competent evidence of identity as defined by the
Notarial Rules as the same person who signs the document in my presence and taken an oath or
affirmation before me as to such document. WITNESS MY HAND AND SEAL THIS 19 th day of
July 2013 in Silang, Cavite.
Doc. No. 307;

Page No. 63;
Book No. 177;
Series of 2013.

x-------------------------------------x
AFFIDAVIT OF LOSS
I, BRIAN L. ROMUALDO, Filipino, of legal age, single and residing at Blk. 218, Lot 6,
Metrogate Silang Estate, Silang, Cavite, after having been duly sworn to in accordance with law do
1. I am a holder and possessor of a passport issued by the Department of Foreign Affairs

(DFA) Manila bearing passport No. EB4908681 issued on March 9, 2012 and will
expires on March 8, 2017;
2. On April 16, 2013, I boarded a passenger bus from Manila going to Silang, Cavite.
3. Only on the following day, April 17, 2013, that I discovered that I left my belt bag
containing my Tourist visa and the aforesaid passport in the aforesaid bus;
4. I exerted all my diligent efforts to locate the same recover the same but to no avail;
5. I executed this affidavit to attest to the truth and veracity of the foregoing statements, to
apprise the Department of Foreign Affairs of the loss of my aforesaid Passport and
Tourist Visa and for all legal intents and purposes this may serve.
IN WITNESS WHEREOF, I have hereunto signed this 7th day of May 2013 in Silang,
Cavite.
BRIAN L. ROMUALDO
Affiant
BEFORE ME, appears the person of BRIAN L. ROMUALDO with his Non-Professional
Driver’s License No. N26-04-003561, expires on 10-30-2015 issued by LTO Tagaytay City
presenting the above Affidavit of Loss who is personally known to me or identified by me through a
competent evidence of identity as defined by the Notarial Rules as the same person who signs the
document in my presence and taken an oath or affirmation before me as to such document.
WITNESS MY HAND AND SEAL THIS 7th day of May 2013 in Silang, Cavite.
Doc. No 184; Atty. IRINEO A. ANARNA

Page No. 38; Notary Public for the Province of Cavite
Book No. 175; Until December 31, 2014
PTR No. 3084694/ 1-02-2013/ TMC
Commission No. RTC TG-12 004
BEFORE ME, a Notary Public for and in the Province of Cavite, this _____ day of
___________, 2015, appears the person of CLIFF I. ACOSTA with his Non-professional Driver’s
License number D18-06-002162 issued by LTO, Tagaytay City valid until 2016-08-23, presenting
the above Secretary’s Certificate who is personally known to me or identified by me through

Aff Loss of Passport

Uploaded by

Copyright:

Available Formats

Aff Loss of Passport

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Aff Loss of Passport

Uploaded by

Copyright:

Available Formats

Republic of the Philippines)

Silang, Cavite ) S.S.

AFFIDAVIT OF LOSS OF PASSPORT

1. I am the holder and possessor of a Philippine Passport duly issued to me by Department of

IN WITNESS WHEREOF, I hereunto signed below.

ANAROSE DOLOSA ASKALI

Doc. No. ____;

AFFIDAVIT OF LOSS OF PASSPORT

IN WITNESS WHEREOF, I hereunto signed below.

ELGYN ABONG PUERTO

Doc. No. ____;

AFFIDAVIT OF LOSS OF PASSPORT

15. I am the holder and possessor of a Philippine Passport duly issued to me by

IN WITNESS WHEREOF, I hereunto signed below.

MAIREN MATIENZO PEREY

AFFIDAVIT OF LOSS OF PASSPORT

I, ANNABELLE M. LOVERO, Filipino, of legal age, widow and residing at Regency

IN WITNESS WHEREOF, I hereunto signed below.

Doc. No. ____;

AFFIDAVIT OF LOSS OF PASSPORT

IN WITNESS WHEREOF, I hereunto signed below.

JOHN MARTIN B. DEJARO

Doc. No. ____;

IN WITNESS WHEREOF, I hereunto signed below.

IVY ROSE CAMAYAN PASANG-BATALLA

40. I am the holder and possessor of a Philippine Passport issued to me by Department of

IN WITNESS WHEREOF, I hereunto signed below.

FLORENCIO MUGAR ESTRADA

Doc. No. ____;

Republic of the Philippines)

46. I am the holder and possessor of a Philippine Passport issued to me by Department of

IN WITNESS WHEREOF, I hereunto signed below.

JURIX ASOY CANGGAS

Doc. No. ____;

Republic of the Philippines)

IN WITNESS WHEREOF, I hereunto signed below.

EDITHA ANDAYA VILLALUNA

Doc. No. ____;

62. I securely place my said passport inside my bag for safekeeping;

IN WITNESS WHEREOF, I hereunto signed below.

BEULAH YVEN ROBLES MALUBAY

Doc. No. ____;

Atty. IRINEO A. ANARNA

Republic of the Philippines)

68. I am the holder and possessor of a Philippine Passport issued to me by Department of

69. I securely place my said passport in my cabinet at my house for safekeeping;

IN WITNESS WHEREOF, I hereunto signed below.

MAC DHARELL JANAP MENDOZA

Doc. No. ____;

Atty. IRINEO A. ANARNA

74. I am the holder and possessor of a Philippine Passport issued to me by Department of

75. I securely place my said passport in my plastic envelope for safekeeping;

IN WITNESS WHEREOF, I hereunto signed below.

REMELYN OBTINALLA MONTEMAYOR

Doc. No. ____;

Republic of the Philippines)

80. I am the holder and possessor of a Philippine Passport issued to me by Department of

IN WITNESS WHEREOF, I hereunto signed below.

HAIDILYN ROBEA BELLEN

Doc. No. ____;