AFFIDAVIT OF LOSS Misplaced

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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAVITE ) S.S.

AFFIDAVIT OF LOSS
I, ANITA NUESTRO MARDO, of legal age, Filipino, with address at
Esperanza Ibaba, Alfonso Cavite after having been sworn to in accordance with law,
hereby depose and state, that:

1. I am in possession of an ATM Card issued by the Philippine


National Bank (PNB) with account no. 504904-18-4000846-4;

2. However, upon checking my files, I found out just recently that the
said ATM card was misplaced and cannot be found;

3. Despite diligent search and efforts to recover the said ATM card the
same can no longer be located;

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


and to request the issuance of a new ATM card to replace the one
that was lost

IN TRUTH WHEREOF, I have hereunto affixed my signature this 27 th day of


January, 2020 at Alfonso, Cavite.

ANITA NUESTRO MARDO


Affiant

SUBSCRIBED AND SWORN to before me this 27 th day of January, 2020 at


Alfonso, Cavite. Affiant exhibiting to me her SSS ID no. 33-8862606-4.

WITNESS MY HAND AND SEAL.

Doc. No. 32 ;
Page No. 8 ;
Book No. LXXVII;
Series of 2020.

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