Affidavit of Loss: IBP No. 017673 July 15, 2017 Tarlac Chapter

REPUBLIC OF THE PHILIPPINES }
PANIQUI, TARLAC } S.S.
AFFIDAVIT OF LOSS
I, JASMIN PAULE CUNANAN, of legal age, Filipino, and with address

at Rizal, Anao,Tarlac, after having been duly sworn to in accordance with law,
hereby depose and state:
1. That I am a member of the Social Security System (SSS) and was issued an

SSS identification card;
2. That sometime on year 2013 I regularly keep the said I.D. in my wallet,
among others and eventually that said I.D. was no longer in my wallet;
3. That for all legal intents and purposes the said Identification Card is now
considered lost and beyond recovery;
4. That I am executing this affidavit to attest to the truth of the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 24 th day of

May 2022, in the Municipality of Paniqui, Province of Tarlac, Philippines.
JASMIN PAULE CUNANAN

Affiant
Passport: P2563593B
SUBSCRIBED AND SWORN to before me this 24th day of May 2022, in

the Municipality of Paniqui, Province of Tarlac, Philippines.
Doc. No. _____; ATTY. JENY ANNE D. MADAMBA

Page No. _____; Notary Public until December 31, 2022
Book No. _____; Carriedo St., Paniqui, Tarlac 2307
Roll No. 69184; May 31, 2017
Series of 2022. PTR No. 5428719; January 03, 2022; Paniqui, Tarlac
IBP No. 017673; July 15, 2017; Tarlac Chapter
MCLE Compliance No. VI-0011044

AFFIDAVIT OF LOSS
I, BELIE P. VICTORINO, of legal age, Filipino, and with address at
Poblacion South, Ramos, Tarlac, after having been duly sworn to in accordance
with law, hereby depose and state:
5. That I am a member of the Social Security System (SSS) and was issued an
UMID card;
6. That I regularly keep the said I.D. in my wallet, among others;
7. That sometime on April 24, 2022, I discovered that said I.D. was no longer
in my wallet;
8. That for all legal intents and purposes the said Identification Card is now
considered lost and beyond recovery;
9. That I am executing this affidavit to attest to the truth of the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of

May 2022, in the Municipality of Paniqui, Province of Tarlac, Philippines.
BELIE P. VICTORINO
Affiant
Pag-Ibig No. 1210-9856-4801
SUBSCRIBED AND SWORN to before me this 13th day of May 2022, in

the Municipality of Paniqui, Province of Tarlac, Philippines.
Doc. No. _____; ATTY. JENY ANNE D. MADAMBA

Page No. _____; Notary Public until December 31, 2022
Book No. _____; Carriedo St., Paniqui, Tarlac 2307
Roll No. 69184; May 31, 2017
Series of 2022. PTR No. 0826876; January 04, 2021; Paniqui, Tarlac
IBP No. 017673; July 15, 2017; Tarlac Chapter
MCLE Compliance No. VI-0011044

AFFIDAVIT OF LOSS
I, FRANKLIN DAGUIO EUGENIO, of legal age, Filipino and with residence

at Sta. Ines East, Sta. Ignacia, Tarlac, after having been duly sworn to in accordance with
law hereby depose and state that:
10. I am a member of the Social Security System (SSS) and was issued an SSS I.D.;
11. I regularly keep the said I.D. in my wallet, among others;
12. Sometime on December 9, 2021, I discovered that said I.D. was no longer in my
wallet, which I believed dropped while riding my bicycle on my way home at Sta.
Ines East, Sta. Ignacia, Tarlac;
13. For all legal intents and purposes the said Identification Card is now considered
lost and beyond recovery;
14. I am executing this affidavit to attest to the truth of the foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 9th day of December
2021 at Paniqui, Tarlac, Philippines.
FRANKLIN DAGUIO EUGENIO

Affiant
SUBSCRIBED AND SWORN TO before me, this 9th day of December 2021 at Paniqui,
Tarlac.

Doc. No. _______
Page No. _______
Book No. _______
Series of 2021.

AFFIDAVIT OF LOSS
I, , of legal age, Filipino and with residence at Paniqui, Tarlac, after

having been duly sworn to in accordance with law hereby depose and
state that:
15. I am a member of the Social Security System (SSS) and was

issued an UMID I.D. by the Social Security System Office, Tarlac;
16. I regularly keep the said UMID I.D. in my wallet, among
others;
17. Sometime on August 2010, when I arrived home from work, I

discovered that said ID card was no longer in my wallet;
18. For all legal intents and purposes the said Identification
Card is now considered lost and beyond recovery;
19. I am executing this affidavit to attest to the truth of the

foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 25th day

of September 2020 at Paniqui, Tarlac, Philippines.
FRANCIS DELA CRUZ OBCENA

Affiant
Driver’s License: C11-07-000693
SUBSCRIBED AND SWORN TO before me, this 25th day of September

2020 at Paniqui, Tarlac.

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

AFFIDAVIT OF LOSS
I, NORMAN DE VERO PONTANILLA, of legal age, Filipino, married

and resident at Paniqui, Tarlac, after having been duly sworn to in
accordance with law hereby depose and state that:
1. I am a member of the Social Security System (SSS) and was issued
an I.D. card with No. 33-0876058-6 by the Social Security System
Office of Tarlac City;
3. That sometime on August 2019, when I arrived home from work, I

discovered that my wallet which contain the above said I.D. was no
longer in my bag;
4. That for all legal intents and purposes the said Identification Card
is now considered lost and beyond recovery;
5. That I am executing this affidavit to attest to the truth of the

foregoing facts.

of September 2019 at Paniqui, Tarlac, Philippines.
NORMAN DE VERO PONTANILLA

Affiant
SUBSCRIBED AND SWORN TO before me, this 19th day of September

2019 at Paniqui, Tarlac, affiant exhibited to me his Pag-Ibig I.D. with No.
1080-0238-3569.

Doc. No. _______
Page No. _______
Book No. _______
Series of 2019.
REPUBLIC OF T
HE PHILIPPINES }
AFFIDAVIT OF LOSS
I, RACQUEL GUIWA ORDONIO, of legal age, Filipino, married and

resident at Paniqui, Tarlac, after having been duly sworn to in
accordance with law hereby depose and state:
1. That I am a member of the Social Security System (SSS) and

was issued an I.D. card with No. 02-1543462-3;
3. That sometime on November 2019, when I arrived home from

work, I discovered that my wallet which contain the above said
I.D. was no longer in my bag;
4. That for all legal intents and purposes the said Identification
Card is now considered lost and beyond recovery;
5. That I am executing this affidavit to attest to the truth of the

foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this 12 day of

March 2020 at Paniqui, Tarlac, Philippines.
RACQUEL GUIWA ORDONIO

Affiant
SUBSCRIBED AND SWORN TO before me, this 12 day of March 2020 at

Paniqui, Tarlac, affiant exhibited to me her Voter’s Identification with No.
6910-0148A-L1273RG020000.

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

AFFIDAVIT OF LOSS
I, ANABELLE TABILISMA BALAOING, of legal age, Filipino, widow

and with residence at San Isidro, Camiling, Tarlac, after having been
duly sworn to in accordance with law hereby depose and state that:
1. I am the wife of the late Antonio Navarro Balaoing;
2. My late husband is a retired military and was issued by the Armed

Forces of the Philippines a Retired Enlisted Personnel Identification
Card;
3. During the lifetime of my husband, he usually kept the said

identification card inside his wallet;
4. Sometime on April 2021, I tried to look for the said identification

among his wallet and I discovered that said ID card was no longer
in his wallet and other personal fi
5. les;
6. For all legal intents and purposes the said Identification Card is
now considered lost and beyond recovery;
7. I am executing this affidavit to attest to the truth of the foregoing

facts.

of May 2021 at Paniqui, Tarlac, Philippines.
ANABELLE TABILISMA BALAOING

Affiant
Umid I.D. No. 0111-5956927-1
SUBSCRIBED AND SWORN TO before me, this 17th day of May 2021 at
Paniqui, Tarlac.

Doc. No. _______
Page No. _______
Book No. _______
Series of 2021.

Affidavit of Loss: IBP No. 017673 July 15, 2017 Tarlac Chapter

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REPUBLIC OF THE PHILIPPINES }

PANIQUI, TARLAC } S.S.

I, JASMIN PAULE CUNANAN, of legal age, Filipino, and with address

1. That I am a member of the Social Security System (SSS) and was issued an

IN WITNESS WHEREOF, I have hereunto set my hand this 24 th day of

JASMIN PAULE CUNANAN

SUBSCRIBED AND SWORN to before me this 24th day of May 2022, in

Doc. No. _____; ATTY. JENY ANNE D. MADAMBA

REPUBLIC OF THE PHILIPPINES }

6. That I regularly keep the said I.D. in my wallet, among others;

IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of

SUBSCRIBED AND SWORN to before me this 13th day of May 2022, in

Doc. No. _____; ATTY. JENY ANNE D. MADAMBA

REPUBLIC OF THE PHILIPPINES }

I, FRANKLIN DAGUIO EUGENIO, of legal age, Filipino and with residence

11. I regularly keep the said I.D. in my wallet, among others;

FRANKLIN DAGUIO EUGENIO

REPUBLIC OF THE PHILIPPINES }

I, , of legal age, Filipino and with residence at Paniqui, Tarlac, after

15. I am a member of the Social Security System (SSS) and was

17. Sometime on August 2010, when I arrived home from work, I

19. I am executing this affidavit to attest to the truth of the

IN WITNESS WHEREOF, I have hereunto set my hand this 25th day

FRANCIS DELA CRUZ OBCENA

SUBSCRIBED AND SWORN TO before me, this 25th day of September

REPUBLIC OF THE PHILIPPINES }

I, NORMAN DE VERO PONTANILLA, of legal age, Filipino, married

2. That I regularly keep the said I.D. in my wallet, among others;

3. That sometime on August 2019, when I arrived home from work, I

5. That I am executing this affidavit to attest to the truth of the

IN WITNESS WHEREOF, I have hereunto set my hand this 19th day

NORMAN DE VERO PONTANILLA

SUBSCRIBED AND SWORN TO before me, this 19th day of September

I, RACQUEL GUIWA ORDONIO, of legal age, Filipino, married and

1. That I am a member of the Social Security System (SSS) and

2. That I regularly keep the said I.D. in my wallet, among others;

3. That sometime on November 2019, when I arrived home from

5. That I am executing this affidavit to attest to the truth of the

IN WITNESS WHEREOF, I have hereunto set my hand this 12 day of

RACQUEL GUIWA ORDONIO

SUBSCRIBED AND SWORN TO before me, this 12 day of March 2020 at

REPUBLIC OF THE PHILIPPINES }

I, ANABELLE TABILISMA BALAOING, of legal age, Filipino, widow

2. My late husband is a retired military and was issued by the Armed

3. During the lifetime of my husband, he usually kept the said

4. Sometime on April 2021, I tried to look for the said identification

7. I am executing this affidavit to attest to the truth of the foregoing

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day

ANABELLE TABILISMA BALAOING

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