This document contains three affidavits of loss from three individuals from Nabua, Camarines Sur, Philippines. The first affidavit is from Roy Christopher Demesa y Uvero who lost his wallet containing cash, car keys, driver's license and other important documents. The second is from Eddie Bardon y Bezica who lost his wallet containing identification cards and receipts. The third is from Benjamin C. Abadilla Jr. who lost his wallet containing his vehicle registration certificate and receipts while in Manila. All three individuals state they made efforts to find the lost items but were unsuccessful, and they are filing the affidavits to establish the losses and request re-issuance of the lost documents and items.
This document contains three affidavits of loss from three individuals from Nabua, Camarines Sur, Philippines. The first affidavit is from Roy Christopher Demesa y Uvero who lost his wallet containing cash, car keys, driver's license and other important documents. The second is from Eddie Bardon y Bezica who lost his wallet containing identification cards and receipts. The third is from Benjamin C. Abadilla Jr. who lost his wallet containing his vehicle registration certificate and receipts while in Manila. All three individuals state they made efforts to find the lost items but were unsuccessful, and they are filing the affidavits to establish the losses and request re-issuance of the lost documents and items.
This document contains three affidavits of loss from three individuals from Nabua, Camarines Sur, Philippines. The first affidavit is from Roy Christopher Demesa y Uvero who lost his wallet containing cash, car keys, driver's license and other important documents. The second is from Eddie Bardon y Bezica who lost his wallet containing identification cards and receipts. The third is from Benjamin C. Abadilla Jr. who lost his wallet containing his vehicle registration certificate and receipts while in Manila. All three individuals state they made efforts to find the lost items but were unsuccessful, and they are filing the affidavits to establish the losses and request re-issuance of the lost documents and items.
Municipality of Nabua ) JOINT AFFIDAVIT OF TWO (2 DISINTERESTED PERSONS We, PONCIANO SABAS, 88 years old, and PURIFICACION SOTO, 8 years old, both !ilipinos, and residents of "napatan, Nabua, Camarines Sur, Philippines after havin# been duly s$orn to in accordance $ith la$, depose and say% &. 'hat $e personally (no$ the person VISITACION MABANSAY JUNIO, bein# the le#itimate dau#hter of the late spouses )uan '. )unio and )ustina *. Mabansay+ ,. 'hat $e also (no$ that the said Visitacion Mabansay Jnio! "#o "as bo$n on Ma$c# %&! %'(% at Ina)atan! Naba! Ca*a$in+s S$! P#i,i))in+s- -. 'hat $e personally a$are and (no$led#eable of birth of said .isitacion Mabansay )unio , for the rason that $e are close ac/uaintances of the above0named person and as a matter of truth and fact $e ma(in# us privy to some family events+ 1. 'hat $e are not parties0in0interset $ith he said person since $e are not related by affinity or consan#uinity+ 2. 'hat $e are e3ecutin# this affidavit to attest to the truth thereof $ithout receivin# any material and re$ard or a promise to receive the same but rather to establish the 4ate 5 Place of 6irth of VISITACION MABANSAY JUNIO , in connection of delayed re#istration $ith the 7ffice of the Civil Re#istrar, Nabua, Camarines sur, Philippines, and for all le#al intents and purposes it may serve. "N W"'N8SS W98R87! , $e have hereunto set pur hands this & th day of May, ,:&1, Nabua, Camarines sur, Philippines. ;;;;;;;;;;;;;;;;;;; ;;;;;;;;;;;;;;;;;;;;; PONCIANO SABAS PURIFICACION SOTO A..iant A..iant ID No/ 0000000000000 ID NO/ 00000000000000 Iss+1 at 0000000000 Iss+1 at 00000000000 S<6SCR"684 =N4 SW7RN to before me this ;;;; day of May, ,:&1, at Nabua, Camarines Sur, Philippines, by the affianst (no$n to me and to me (no$n to be the same persons $ho personally e3ecuted and si#ned the fore#oin# affidavit and personally ac(no$led#ed before me that the same are their free and voluntary act and deed and " hereby certify that " have personally e3amined the affiant and " am satisfied that they voluntarily e3ecuted and understood the fore#oin# affidavit. 4oc. No. ;;;;;;;;+ ROMEO BE2MONTE ABACA! JR/ Pa#e No. ;;;;;;;;+ N7'=R> P<6?"C 6oo( No. @"" + <ntil 4ecember -&, ,:&1 Series of ,:&1+ P'R N7. 2-2&A&08 &BAB&1 "6P N7. 88A:-, &,BB&, Roll of =ttorney No. 2,1- Republic of the Philippines) Province of Camarines Sur) s.s. Municipality of Nabua ) AFFIDAVIT OF LOSS I, ROY CHRISTOPHER DEMESA Y UVERO,36 years ol, marrie, resient of !aran"ay #oures $l, Nabua, Camarines Sur, after havin" been uly s%orn to in accorance %ith la%, epose an say& '. (hat I am the holer)o%ner of the follo%in" items, to %it& a. Php *++.++ , cash b. -(M Car .-/!) c. Professional 0river1s #icense . Importants ocuments 2. (hat on or about 3&++ p.m. of 0ecember 23, 2+'3, %hile I %as at !r"y. Santia"o $l, Nabua, Camarines Sur, I notice)foun out that my blac4 %allet %hich I place in my blac4 slin" ba" containin" the above,mentione items %as lost5 -. 'hat the said Professional 4rivers ?icense $as never confiscatedBapprehended by any traffic officer or la$ enforcer+
6. (hat I e7erte efforts to locate but resulte in vain5 6. (hat I am e7ecutin" this affiavit to establish the sai loss an in orer to support my re8uest for re,issuance of the above,mentione items, for all le"al intents an purposes it may serve. IN 9I(N:SS 9;:R:$<, I have hereunto set my han this 26th of 0ecember, 2+'3 at Nabua, Camarines Sur, Philippines. ROY CHRISTOPHER DEMESA Y UVERO Affiant PASSPORT NO. EB4185195 At DFA L!"a#$i Cit% On D!&!'(!) 1 *+11
S/!SCRI!:0 -N0 S9$RN to before me this 26 (; 0-= $< 0ecember, 2+'3 at Nabua, Camarines Sur, Philippines, by the affiant 4no%n to me an to me 4no%n to be the same person %ho personally e7ecute an si"ne the fore"oin" affiavit an personally ac4no%le"e before me that the same is his free an voluntary act an ee an I hereby certify that I have personally e7amine the affiant an I am satisfie that he voluntarily e7ecute an unerstoo the fore"oin" affiavit. Republic of the Philippines) Province of Camarines Sur) s.s. Municipality of Nabua ) AFFIDAVIT OF 2OSS ", 844"8 6=R47N > 68?*"C=, 21 years old, married, resident of 6aran#ay ?ourdes >oun#, Nabua, Camarines Sur, after havin# been duly s$orn to in accordance $ith la$, depose and say% ,. 'hat " am the holderBo$ner of the follo$in# "dentification Cards, to $it% 2. Php :.:: cash . CP= Professional "4 A. P"CP= "4 8. "ntelicare 9ealth Card C. Philhealth "4 &:. '"N "4 &&. Pertinent receipts ,. 'hat on or about %:: p.m. of 4ecember &, ,:&-, $hile " $as at Nbua Public Mar(et, Poblacion, Nabua, Camarines Sur, " noticedBfound out that my bro$n $allet $hich " placed in my ri#ht bac( poc(et of my $orn pants $as lost, $hich unfortunately included the above0mentioned "dentification Cards and pertinent receipts and " believed that have un(no$in#ly slipped off from my poc(et+ -. 'hat " e3erted efforts to locate but resulted in vain+ 1. 'hat " am e3ecutin# this affidavit to establish the said loss and in order to support my re/uest for re0issuance of the above0mentioned "dentification Cards, for all le#al intents and purposes it may serve. "N W"'N8SS W98R87!, " have hereunto set my hand this &8th of 4ecember, ,:&- at Nabua, Camarines Sur, Philippines. EDDIE BARDON Y BE23ICA A..iant TIN NO/ %45674567(8 At BIR! I$i9a City
S<6SCR"684 =N4 SW7RN to before me this &8 '9 4=> 7! 4ecember, ,:&- at Nabua, Camarines Sur, Philippines, by the affiant (no$n to me and to me (no$n to be the same person $ho personally e3ecuted and si#ned the fore#oin# affidavit and personally ac(no$led#ed before me that the same is his free and voluntary act and deed and " hereby certify that " have personally e3amined the affiant and " am satisfied that he voluntarily e3ecuted and understood the fore#oin# affidavit. Republic of the Philippines) Province of Camarines Sur) s.s. Municipality of Nabua ) AFFIDAVIT OF 2OSS ", BENJAMIN C/ ABA22A! JR/! married, of le#al a#e, !ilipino, resident of 6aran#ay San Ramon So#od, ?a 7pinion, Nabua, Camarines Sur, after havin# been duly s$orn to in accordance $ith la$, depose and say% -. 'hat " am the holderBo$ner of Certificate of Re#istration of my motor vehicle, under CR No. &&:C&221+
,. 'hat on September &2, ,:&-, $hile " $as in Manila, " noticedBfound out that my $allet $hich " placed in my ri#ht bac( poc(et of my pants $as lost, $hich unfortunately included the above0mentioned Certificate of Re#istration, and pertinent receipts and " believed that have un(no$in#ly slipped off from my poc(et+ -. 'hat " e3erted efforts to locate but resulted in vain+ 4. That I now request the Land Transportation Office to issue a new Certificate of Registration in lieu of the lost. 5. That each and every fact herein stated is true and I am willing to testify efore any court of !ustice to sustantiate the truth of each and all the said facts. 1. 'hat " am e3ecutin# this affidavit to establish the said loss and in order to support my re/uest for re0issuance of the above0mentioned Certificate of Re#istration, for all le#al intents and purposes it may serve. "N W"'N8SS W98R87!, " have hereunto set my hand this ,-rd of 4ecember, ,:&- at Nabua, Camarines Sur, Philippines. BENAJMAMIN C/ ABA22A! JR/ A..iant ID NO/0000000000000000000000 Iss+1 at 00000000000000000000 On 000000000000000000000000
S<6SCR"684 =N4 SW7RN to before me this ,-rd 4=> 7! 4ecember, ,:&- at Nabua, Camarines Sur, Philippines, by the affiant (no$n to me and to me (no$n to be the same person $ho personally e3ecuted and si#ned the fore#oin# affidavit and personally ac(no$led#ed before me that the same is his free and voluntary act and deed and " hereby certify that " have personally e3amined the affiant and " am satisfied that he voluntarily e3ecuted and understood the fore#oin# affidavit. Republic of the Philippines) Province of Camarines Sur) s.s. Municipality of Nabua ) AFFIDAVIT OF 2OSS ", 844"8 6=R47N > 68?*"C=, 21 years old, married, resident of 6aran#ay ?ourdes >oun#, Nabua, Camarines Sur, after havin# been duly s$orn to in accordance $ith la$, depose and say% 1. 'hat " am the holderBo$ner of the follo$in# "dentification Cards, to $it% &,. Php :.:: cash &-. CP= Professional "4 &1. P"CP= "4 &2. "ntelicare 9ealth Card &. Philhealth "4 &A. '"N "4 &8. Pertinent receipts ,. 'hat on or about %:: p.m. of 4ecember &, ,:&-, $hile " $as at Nbua Public Mar(et, Poblacion, Nabua, Camarines Sur, " noticedBfound out that my bro$n $allet $hich " placed in my ri#ht bac( poc(et of my $orn pants $as lost, $hich unfortunately included the above0mentioned "dentification Cards and pertinent receipts and " believed that have un(no$in#ly slipped off from my poc(et+ -. 'hat " e3erted efforts to locate but resulted in vain+ 1. 'hat " am e3ecutin# this affidavit to establish the said loss and in order to support my re/uest for re0issuance of the above0mentioned "dentification Cards, for all le#al intents and purposes it may serve. "N W"'N8SS W98R87!, " have hereunto set my hand this &8th of 4ecember, ,:&- at Nabua, Camarines Sur, Philippines. EDDIE BARDON Y BE23ICA A..iant TIN NO/ %45674567(8 At BIR! I$i9a City
S<6SCR"684 =N4 SW7RN to before me this &8 '9 4=> 7! 4ecember, ,:&- at Nabua, Camarines Sur, Philippines, by the affiant (no$n to me and to me (no$n to be the same person $ho personally e3ecuted and si#ned the fore#oin# affidavit and personally ac(no$led#ed before me that the same is his free and voluntary act and deed and " hereby certify that " have personally e3amined the affiant and " am satisfied that he voluntarily e3ecuted and understood the fore#oin# affidavit. PRO,ECT IN MA-ABAYA N Submitted to% MRS/ 2EI2A :/ DURAN SubDect 'eacher Submitted by%
RA2P: SI2VESTER B/ 22ORIN 3$a1+ IV6A Repulic of the "hilippines # "rovince of Camarines $ur # $.$. %unicipality of &aua # ' ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ' AFFIDAVIT OF LOSS I) JENNIFER ATIAN-AGUILAR, 5* years old) married) +ilipino) and resident of &o. ,4 -one , "arish $t. $an Roque "olacion) &aua) Camarines $ur) "hilippines) after eing duly sworn to in accordance with law) herey depose and state. /. That I am the holder0owner of "ermanent Resident Card) 1nited $tate of 2merica3 ,. That as a result of transferring from one location to another) the "ermanent Card which was inserted on my passport was missing on &ovemer ,4) ,5/4 upon my arrival at &inoy 2quino International 2irport) Terminal ,) "asay City) and diligent search made and underta6en such that I now elieve that the same is lost eyond recovery3 4. That I e'erted efforts to locate ut resulted in vain3 4. That I now request the 1nited $tate of 2merica to issue a new "ermanent Resident Card in lieu of the Cards that was lost. 5. That each and every fact herein stated is true and I am willing to testify efore any court of !ustice to sustantiate the truth of each and all the said facts. I& 7IT&8$$ 798R8O+) I have hereunto set my hand this ,:th day of &ovemer) ,5/4 at &aua) Camarines $ur) "hilippines.
JENNIFER ATIAN6A3UI2AR Affiant ID NO._______________________ Issued at ____________________ On ___________________ SUBSCRIBED AND SWORN to efore me this ,:th day of &ovemer) ,5/4 at &aua) Camarines $ur) y the affiant 6nown to me and to me 6nown to e the same person who personally e'ecuted and signed the foregoing affidavit and personally ac6nowledged efore me that the same is her free and voluntary act and deed and I herey certify that I have personally e'amined the affiant and I am satisfied that she voluntarily e'ecuted and understood the foregoing affidavit. ;oc. &o. <<<<<<<<3 ROMEO BELMONTE ABACA, JR "age &o. <<<<<<<<3 &OT2R= "1>LIC >oo6 &o. ?II 3 1ntil ;ecemer 4/) ,5/4 $eries of ,5/43 "TR &O. /4@A,@4(C /0:0/4
Republic of the Philippines) Province of Camarines Sur) s.s. Municipality of Nabua ) AFFIDAVIT OF 2OSS ", TERESITA R/ BA22ERDA! !ilipino, of le#al a#e, $ido$, resident of Santia#o >oun#, Nabua, Camarines Sur, Philippines, after havin# been duly s$orn to in accordance $ith la$, depose and say% &. 'hat " am a planholder of St. Peter ?ife Plan, "nc. St. Peter ?ife Plan 6uildin#, EueFon =venue cor. No. , West 1 th St. EueFon City+ ,. 'hat " $as issued a Policy Contract by the St. Peter ?ife Plan, "nc.
-. 'hat sometime in the month of September, ,:&-, at my house in Santia#o >oun#, Nabua, Camarines Suir, " noticedBfound out that my bro$n envelope $hich " placed in my cabinet $as lost, $hich unfortunately included the above0mentioned policy contract and pertinent receipts+ 1. 'hat " e3erted efforts to locate but resulted in vain+ 2. 'hat " am e3ecutin# this affidavit to establish the truth of the fore#oin# statements. "N W"'N8SS W98R87!, " have hereunto set my hand this ;;;; h day of )anuary, ,:&1 at Nabua, Camarines Sur, Philippines. TERESITA R/ BA22ERDA A..iant ID NO/ N%%5(''88P Iss+1 at I$i9a City On Ma$c# %(! 2;%%- S<6SCR"684 =N4 SW7RN to before me this ;;;; th day of )anuary, ,:&1 at Nabua, Camarines Sur, Philippines, by the affiant (no$n to me and to me (no$n to be the same person $ho personally e3ecuted and si#ned the fore#oin# affidavit and personally ac(no$led#ed before me that the same is her free and voluntary act and deed and " hereby certify that " have personally e3amined the affiant and " am satisfied that she voluntarily e3ecuted and understood the fore#oin# affidavit. 4oc. No. ;;;;;;;;+ Ps#e No. ;;;;;;;;+ 6oo( No. ;;;;;;;+ Series of ,:&1 4oc. No. ;;;;;;;;+ ROMEO BE2MONTE ABACA! JR/ Pa#e No. ;;;;;;;;+ N7'=R> P<6?"C 6oo( No. vii + <ntil 4ecember -&, ,:&1 Series of ,:&-+ P'R N7. &-C,C10C &B8B&- "6P N7. 88A:-, &,BB&, Roll of =ttorney No. 2,1- Republic of the Philippines) Province of Camarines Sur) s.s. Municipality of Nabua ) AFFIDAVIT OF 2OSS ", RIC CA2ME y PERE<! 1: years old, !ilipino, married, and a resident of Gone ,, 6r#y. Cristo Rey, 6ato, Camarines Sur, Philippines, after havin# been duly s$orn to in accordance $ith la$, depose and say% &C. 'hat " am the o$ner of .oterHs "4 Card+ Community 'a3 Clearance and Professional 4riverHs ?icense+ ,. 'hat sometime on =u#ust, ,:&-, $hile " $as travellin# in a passen#er bus from 6ato, Camarines Sur to$ards Metro Manila, and $hile the said passen#er bus $as about to stop in a canteen located at ?ucena City , " noticed that my $allet $hich " placed in my bac( poc(et of my short pants $as lost, $hich unfortunately included the above0mentioned "dentification Cards and the amount of P&,-::.::, and " believed that have un(no$in#ly slipped off from my poc(et+ -. 'hat " e3erted efforts to locate but resulted in vain+ 1. 'hat the said Professional 4rivers ?icense $as never confiscatedBapprehended by any traffic officer or la$ enforcer+
-. 'hat " am e3ecutin# this affidavit to establish the said loss and in order to support my re/uest for re0issuance of the above0mentioned "dentification Cards, for all le#al intents and purposes it may serve. 1. "N W"'N8SS W98R87!, " have hereunto set my hand this ,1 rd of 7ctober, ,:&- at Nabua, Camarines Sur, Philippines. RIC CA2ME y PERE< A..iant Pass)o$t no/ EB(%;42'2 Iss+1 by DFA S<6SCR"684 =N4 SW7RN to before me this ,1 '9 4=> 7! 7ctober, ,:&- at Nabua, Camarines Sur, Philippines, by the affiant (no$n to me and to me (no$n to be the same person $ho personally e3ecuted and si#ned the fore#oin# affidavit and personally ac(no$led#ed before me that the same is his free and voluntary act and deed and " hereby certify that " have personally e3amined the affiant and " am satisfied that he voluntarily e3ecuted and understood the fore#oin# affidavit. 4oc. No. ;;;;;;;;+ ROMEO BE2MONTE ABACA! JR/ Pa#e No. ;;;;;;;;+ N7'=R> P<6?"C 6oo( No. .""" + <ntil 4ecember -&, ,:&1 Series of ,:&-+ P'R N7. &-C,C10C &B8B&- "6P N7. 88A:-, &,BB&, Roll of =ttorney No. 2,1- Republic of the Philippines) Province of CamarinesSur ) S.S. Municipality of Nabua ) AFFIRMATION OF WITNESS ", ROMAN 3WY22EN FORTUNO 2ADAW, of le#al a#e, !ilipino, married, resident of San Mi#uel, Nabua, Camarines Sur, Philippines, after havin# been duly s$orn to in accordance $ith la$, depose and say% &. 'hat " personally (no$ 9onorio R. !ortuno ma(in# the ac(no$led#ment named in the 83tra0)udicial Settlement of 8state $ith Waiver of Ri#hts+
,. 'hat " $as present $hen 9onorio R. !ortuno si#ned the said document+ -. 'hat 9onorio R. !ortuno does not si#ned the said document instead he used his ri#ht thumb mar(+ 1. 'hat " do not have financial interest in the document bein# ac(no$led#e. 47N8 this Ath day of September, ,:&-, at Nabua, Camarines Sur, Philippines, ROMAN 3WY22EN F/ 2ADAW =ffiant "4 No.&060&:-AC "ssued on 4ecember ,-, ,:&& =t Camp Crame, EueFon City " 98R6> C8R'"!> that " have e3amined personally the above0named $itness, and avo$ed to the penalty of la$ to the truthfulness of the $hole contents. ATTY/ ROMEO B/ ABACA! JR/ Nota$y Pb,c DAVIT OF 2OSS ", A2TON A/ REONA2, married, of le#al a#e, !ilipino, and resident of ?ourdes >oun#, Nabua, Camarines Sur, Philippines, after havin# been duly s$orn to in accordance $ith la$, depose and say% &. 'hat " am the o$ner of an "dentification Card $ith Number :8:2&&A,811, duly issued by the Philippine 9ealth "nsurance Corporation+ ,. 'hat sometime on the month of =u#ust, ,:&-, $hile " $as on my from ?a#una #oin# bac( to my residence at Nabua, Camarines Sur, " found out that the afore0cited "dentification Card $hich " placed in my travellin# ba# $as lost+ -. 'hat " e3erted my l efforts to locate but resulted in vain+ 1. 'hat " am e3ecutin# this affidavit in order to attest to the truth of the for#oin# facts and to support my re/uest for re0issuance of the same $ith the 7ffice of Philippine 9ealth "nsurance Corporation, for all le#al intents and purposes it may serve. "N W"'N8SS W98R87!, " have hereunto set my hand this ;;;th day of September, ,:&-, at Nabua, Camarines Sur, Philippines. A2TON A/ REONA2 =ffiant "4 N7. ;;;;;;;;;;;;;; .=?"4 <N'"?;;;;;;; =';;;;;;;;;;;;;;;; S<6SCR"684 =N4 SW7RN to before me this ;;;'9 4=> 7! September, ,:&-, at Nabua, Camarines Sur, Philippines. 4oc. No. ;;;;;;;;;+ Pa#e No. ;;;;;;;;;+ 6oo( No. ;;;;;;;;;+ Series of ,:&-+