Mark Jay Gallego Lopez filed an affidavit stating that he lost his Professional Regulation Commission identification card for registered nurses. In October 2012, Lopez discovered his wallet was missing, which contained his PRC ID card. Despite searching diligently, Lopez was unable to find the lost card. Lopez affirmed that the card was not confiscated by authorities. He executed the affidavit to attest to these facts and request a replacement PRC ID card from the commission.
Mark Jay Gallego Lopez filed an affidavit stating that he lost his Professional Regulation Commission identification card for registered nurses. In October 2012, Lopez discovered his wallet was missing, which contained his PRC ID card. Despite searching diligently, Lopez was unable to find the lost card. Lopez affirmed that the card was not confiscated by authorities. He executed the affidavit to attest to these facts and request a replacement PRC ID card from the commission.
Mark Jay Gallego Lopez filed an affidavit stating that he lost his Professional Regulation Commission identification card for registered nurses. In October 2012, Lopez discovered his wallet was missing, which contained his PRC ID card. Despite searching diligently, Lopez was unable to find the lost card. Lopez affirmed that the card was not confiscated by authorities. He executed the affidavit to attest to these facts and request a replacement PRC ID card from the commission.
Mark Jay Gallego Lopez filed an affidavit stating that he lost his Professional Regulation Commission identification card for registered nurses. In October 2012, Lopez discovered his wallet was missing, which contained his PRC ID card. Despite searching diligently, Lopez was unable to find the lost card. Lopez affirmed that the card was not confiscated by authorities. He executed the affidavit to attest to these facts and request a replacement PRC ID card from the commission.
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AFFIDAVIT OF LOSS OF IDENTIFICATION CARD
REPUBLIC OF THE PHILIPPINES )
CITY OF MANILA ) SS.
I, MARK JAY GALLEGO LOPEZ, Filipino, of legal age, single, and a resident of 56 Tirad Pass, Bagong Barrio, Caloocan City, after having been duly sworn in accordance with law, hereby depose and say: 1. That I am a holder of a professional identification card issued by the Professional Regulation Commission (PRC) for being a Registered Nurse; 2. That sometime on October, 2012, I discovered that my wallet was missing where I used to put my PRC identification card, among others;
3. That diligent search of said PRC Identification card proved futile and unavailing;
4. That said ID card was not confiscated by the authorities by reason of violation of any rules and regulations; 5. That I am executing this affidavit to attest to the truth of the foregoing facts and to request for a replacement of said PRC ID card from the Professional Regulation Commission. IN WITNESS WHEREOF, I have hereunto affixed my signature this 8 th day of November 2012 at Manila, Philippines.
_________________________________ MARK JAY G. LOPEZ Affiant
SUBSCRIBED AND SWORN to before me, this ______ day of November, 2012 in the City of Manila, affiant exhibiting before me his ______________________, issued at ______________ on _____________.
Notary Public
Doc. No. ..; Page No. .; Book No. .; Series of 2012.