REPUBLIC OF THE PHILIPPINES)
PROVINCE OF NUEVA ECIJA )
CITY OF CABANATUAN )S.S.
X---------------------------X
AFFIDAVIT OF LOSS
I, MARIA ANA A. MANUEL, of legal age, Filipino and a resident of
Brgy. Aduas Sur, Cabanatuan City, Nueva Ecija, after having been duly sworn to in
accordance with law hereby depose and say:
1. That I am a bona fide member of Social Security System (SSS) and a
lawful holder of SSS ID No. 33-6084325-0;
2. That the said SSS ID was lost/misplaced in my possession;
3. That despite diligent search to locate the said SSS ID but to no avail;
4. That I am executing this affidavit to attest to the truth of the foregoing
and to report this matter to the authorities because maybe it can be
used to any illegal act and hereby request for the replacement of the
said lost item.
IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of
______________ 2020 , here at Cabanatuan City.
MARIA ANA A. MANUEL
Affiant
SUBSCRIBED AND SWORN to before me this ___ day of
___________ 2020, here at Cabanatuan City.
Doc. No. ______;
Page No. ______;
Book No. _____;
Series of 2020.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF NUEVA ECIJA )
CITY OF CABANATUAN )S.S.
X---------------------------X
AFFIDAVIT OF LOSS
I, RINIUS TIONGSON CHUA of legal age, Filipino, married and a
resident of Irenville Subdivison, Brgy. San Isidro, Cabanatuan City, Nueva Ecija,
after having been duly sworn to in accordance with law hereby depose and say:
1. That I am a bona fide member of Social Security System with SSS No. 02-1636220-
2 and a lawful holder of SSS ID;
2. That the said SSS ID was lost/misplaced unwittingly in my possession;
3. That despite diligent search to locate the said SSS ID same could no longer be
located hence it was deemed lost;
4. That I am executing this affidavit to attest to the truth of the foregoing and to report
this matter to the authorities because maybe it can be used to any illegal act and
hereby request for the replacement of the said lost item.
IN WITNESS WHEREOF, I have hereunto set my hand this 19th day of
June 2018, here at Cabanatuan City.
RINIUS T. CHUA
Affiant
SUBSCRIBED AND SWORN to before me this 19th day of June 2018,
here at Cabanatuan City.
Doc. No. ______;
Page No. ______;
Book No. _____;
Series of 2018.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF NUEVA ECIJA )
CITY OF CABANATUAN )S.S.
X---------------------------X
AFFIDAVIT OF LOSS
I, CHONA C. QUERIJERO-AURO of legal age, Filipino, married and a
resident of Brgy. Bonifacio Ext. Baler, Aurora, after having been duly sworn to in
accordance with law hereby depose and say:
1. That I am a bona fide member of Social Security System with SSS No. 33-
5516645-0 and a lawful holder of SSS ID;
2. That the said SSS ID was lost/misplaced unwittingly in my possession;
3. That despite diligent search to locate the said SSS ID same could no
longer be located hence it was deemed lost;
4. That I am executing this affidavit to attest to the truth of the foregoing and
to report this matter to the authorities because maybe it can be used to any
illegal act and hereby request for the replacement of the said lost item.
IN WITNESS WHEREOF, I have hereunto set my hand this 19th day of
June 2018, here at Cabanatuan City.
CHONA C. QUERIJERO-AURO
Affiant
SUBSCRIBED AND SWORN to before me this 19th day of June 2018,
here at Cabanatuan City.
Doc. No. ______;
Page No. ______;
Book No. _____;
Series of 2018.
