Affidavit of Loss of PPSTA

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REPUBLIC OF THE PHILIPPINES)

CEBU CITY) SS
AFFIDAVIT OF LOSS

I, SHIEKA MAE LALIYAH, of legal age, widow, residing at B37 L23 Bayswater Subd,
Agus, Lapu-Lapu City, Philippines after being sworn in accordance with law, depose and say:

1. That I am the daughter of ESTELA BATUHAN LALIYAH who died on June 9, 2020;

2. That during the lifetime of my mother, she was a teacher and a member of Philippine
Public School Teachers Association (PPSTA) and acquired a PPSTA Membership
Certificate for Mutual Aid System 65 (MAS 65) and Mutual Retirement Benefit
System Plus (MRBS Plus);

3. That sometime after the death of my mother, we could no longer find the
abovementioned documents since it was her who kept the copy of the said
documents;

4. That I diligently exerted efforts to locate the said documents, but despite a diligent
search it could not be found, hence the same is deemed lost and at a point beyond
recovery;

5. That I am executing this affidavit to attest to the truth and veracity of the foregoing
facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this August 11, 2022, in Cebu
City, Philippines.

SHIEKA MAE LALIYAH


Affiant
G01-19-002610
Non-Professional Driver’s License

SUBSCRIBED AND SWORN to before me this 11th day of August 2022 at Cebu City,
Philippines, affiant personally known to me with his competent evidence of identity
abovementioned to be the same person who executed the foregoing affidavit and avowed,
and who signed this instrument in my presence, and avowed under the penalty of law to the
whole truth of its contents.

Doc. No. ____;


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

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