Republic of the Philippines)

Province of Southern Leyte)

Municipality of SOGOD )
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AFFIDAVIT OF LOSS

I, PAULINA A. MAGAIPO, of legal age, married, Filipino and a resident of Brgy.

Kawayan, Libagon, Southern Leyte, after having been duly sworn to an oath in accordance with
law, hereby depose and say:

1. That I am a registered voter of Kawayan, Libagon, Southern Leyte and such I was
issued a Voter’s ID by the Commission on Elections (COMELEC);

2. That the aforementioned Voter’s I.D. was placed inside my wallet;

3. That sometime on September 2017, the aforementioned Voter’s ID got lost and
nowhere to be found;

4. That I exerted an exhaustive efforts to locate the same but my search proved futile as
I could not locate the same up to the present;

5. That I executed this affidavit in order to attest to the truth and veracity of the
foregoing so that I may be issued another one and for whatever legal intents and
purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 11th December 2017 in
the Municipality of Sogod, Southern Leyte, Philippines.

PAULINA A. MAGAIPO
Affiant

OSCA No: 01551

SUBSCRIBED AND SWORN to before me this 11th December 2017 in the Municipality
of Sogod, Southern Leyte, Philippines