AFFIDAVIT OF LOSS
2. That sometime on the 5th day of June 2016, I noticed that the
envelope where my Pass Book was enclosed was lost;
3. That diligent efforts were exerted to look for the said envelope as
well as my Pass Book but such efforts proved futile;
IN WITNESS WHEREOF, I have hereunto affix my signature this 10th day of June
2016, in the City of Malabon, Philippines
ZENAIDA S. MACABENTA
Affiant
SUBSCRIBED AND SWORN TO before me on this 10th day of June 2016. Affiant
exhibiting to me her Senior Citizen ID with Control No. 003052.