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REPUBLIC OF THE PHILIPPINES )

CITY OF CABANATUAN ) S.S.

AFFIDAVIT

I, AYISHA JAIDY M. MIGUEL, of legal age, Filipino, and a resident of Brgy. San
Cristobal, Licab, Nueva Ecija after having been sworn to in accordance with law,
hereby depose and state:

1. That my grandmother ERLINDA B. MORALES is the owner of the Philippine


National Bank ATM Savings Account Card with No. 4844763-00014 ;

2. That I have been authorized by her to withdraw from the said ATM savings
account ;

3. That on August 3, 2017, I went to ATM Machine located at Maharlika hi-way,


Dicarma, Cabanatuan City to withdraw my money amounting to Fifteen
Thousand Seven Hundred Pesos (P15, 700.00). I found out that my available
balance was no longer sufficient for my withdrawal ;

4. That the last withdrawal that I made from the said Account was on July 10, 2017
thru ATM Machine located at Roxas, Isabela Branch ;

5. That I went inside the BANK to inquire for Statement of Account. The Bank
personnel informed me that there were withdrawal including charges on my
grandmothers ATM savings Account amounting to Thirteen Thousand Seven
Hundred Pesos (P13, 700.00) and the withdrawal was made thru ATM Machine
located in a place where I did not go ;

6. That I am requesting the Philippine National Bank for further investigation on my


account since I did not allow anybody or authorized anybody to withdraw from
the above mentioned amount ;

7. That I am executing this affidavit to tell the truth regarding this matter and to get
to the bottom of this incident.

IN WITNESS WHEREOF, I have hereunto set my signature this 15 th day of


August, 2017 at Cabanatuan City.

AYISHA JAIDY M. MIGUEL


Affiant

SUBSCRIBED AND SWORN to before me at the place and date above stated. I hereby
certify that I personally examined the affiant and am convinced that she voluntarily executed the
foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc No. 501


Page No. 102
Book 60
Series of 2017
REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, MYRON RENZ M. DOMINGO, of legal age, Filipino, single and a resident of


Mabini Extension, Cabanatuan City, Nueva Ecija after having been sworn to in
accordance with law, hereby depose and state:

8. That I am a client of Philippine National Bank in Maharlika highway, Dicarma,


Cabanatuan City;

9. That as a client, I am a holder of ATM card;

10. That due to unavoidable circumstances, my Savings ATM card was lost and
despite my diligent search, I can no longer locate the same; and

11. That I am executing this affidavit to support my request with the Savings for
the reissuance of a new ATM Card and for whatever legal purpose it may
serve.

IN WITNESS WHEREOF, I have hereunto set my signature this 14 th day of


March, 2017 at Cabanatuan City.

MYRON RENZ M. DOMINGO

Affiant

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that he
voluntarily executed the foregoing affidavit, read the same and understood its
contents.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc No. _____;


Page No._____;
Book 57
Series of 2017
REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, LILIBETH B. VALEA, of legal age, Filipino, and a resident of 68 Gen. Luna


St., Laur, Nueva Ecija after having been sworn to in accordance with law, hereby
depose and state:

12. That I am a depositor of China Banking Corporation in Maharlika Highway,


Cabanatuan City;

13. That as a depositor of China Bank, I am a holder of China Bank ATM card with
account number 264-108961-1;

14. That due to unavoidable circumstances, my ATM card was lost and despite my
diligent search, I can no longer locate the same; and

15. That I am executing this affidavit to support my request with the China Bank for
the reissuance of a new ATM Card and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my signature this 14 th day of


November, 2016 at Cabanatuan City.

LILIBETH B. VALEA
Affiant

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that she
voluntarily executed the foregoing affidavit, read the same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc No. 524


Page No. 106
Book 53
Series of 2016

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS
I, SUSANA I. SOLIMAN, of legal age, Filipino, and a resident of
Cabanatuan City, Nueva Ecija after having been sworn to in accordance
with law, hereby depose and state:

16. That I am a depositor of China Banking Corporation in Maharlika


Highway, Cabanatuan City;

17. That as a depositor of China Bank, I am a holder of China Bank ATM


card with ATM Card No. 16401-0031691;

18. That due to unavoidable circumstances, my ATM card was lost and
despite my diligent search, I can no longer locate the same; and

19. That I am executing this affidavit to support my request with the China
Bank for the closing of my ATM Account and for whatever legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my signature this _____ th


day of ___________, 2016 at Cabanatuan City.

SUSANA I. SOLIMAN
Affiant

SUBSCRIBED AND SWORN to before me at the place and date above


stated. I hereby certify that I personally examined the affiant and am
convinced that he volunta-rily executed the foregoing affidavit, read the
same and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, JONNEL P. REYES, of legal age, Filipino, and a resident of Mabuga,


Gapan, Nueva Ecija after having been sworn to in accordance with law,
hereby depose and state:

20. That I am a depositor of China Banking Corporation in Maharlika


Highway, Cabanatuan City;

21. That as a depositor of China Bank, I am a holder of China Bank ATM


card with ATM Card No. 16401-008741;
22. That due to unavoidable circumstances, my ATM card was lost and
despite my diligent search, I can no longer locate the same; and

23. That I am executing this affidavit to support my request with the China
Bank for the closing of my ATM Account and for whatever legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my signature this 29 th day


of April, 2015 at Cabanatuan City.

JONNEL P. REYES
Affiant
Emp. Id No. AU-10-053-F

SUBSCRIBED AND SWORN to before me at the place and date above


stated. I hereby certify that I personally examined the affiant and am
convinced that he voluntarily executed the foregoing affidavit, read the same
and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

ATTY. JEREMIAS C. GARCIA


Doc. No. 192 Notary Public
Page No. 40 Until December 31, 2016
Book 46 PTR No. CBN-0642064, 1-5-2015, Cab. City
Series of 2015 IBP No. 0981182, 12-22-14 (for 2015) IBP HQ
Roll No. 45770, MCLE V-0006030

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, PAULINO O. RULLAN, of legal age, Filipino, and a resident of


Cabanatuan City, Nueva Ecija after having been sworn to in accordance
with law, hereby depose and state:

24. That I am a depositor of China Banking Corporation in Maharlika


Highway, Cabanatuan City;

25. That as a depositor of China Bank, I am a holder of China Bank ATM


card with ATM Card No. 171-01-000033;

26. That due to unavoidable circumstances, my ATM card was lost and
despite my diligent search, I can no longer locate the same; and

27. That I am executing this affidavit to support my request with the China
Bank for the reissuance of a new ATM card to replace my lost ATM card.
IN WITNESS WHEREOF, I have hereunto set my signature this____ day
of _______________________at Cabanatuan City.

PAULINO O. RULLAN
Affiant

SUBSCRIBED AND SWORN to before me at the place and date above


stated. I hereby certify that I personally examined the affiant and am
convinced that he voluntarily executed the foregoing affidavit, read the same
and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, MIGUEL MADISON DE GUZMAN, of legal age, Filipino, single and a resident


of Maugat, San Antonio, Nueva Ecija, after having been sworn to in
accordance with law, hereby depose and state:

28. That I am a depositor of ALLIED BANK in Maharlika Highway, Cabanatuan City


with account no. 0476-01980-7;

29. That as a depositor of Allied Bank, I am a holder of Allied Bank ATM card;

30. That due to unavoidable circumstances, my ATM card was lost and despite
my diligent search, I can no longer locate the same; and

31. That I am executing this affidavit to support my request with the Allied Bank
for the reissuance of a new ATM card to replace my lost ATM card.

IN WITNESS WHEREOF, I have hereunto set my signature this____ day of


_______________________at Cabanatuan City.

MIGUEL MADISON DE GUZMAN


Affiant

SUBSCRIBED AND SWORN to before me at the place and date above stated. I
hereby certify that I personally examined the affiant and am convinced that he
voluntarily executed the foregoing affidavit, read the same and understood its
contents.

WITNESS MY HAND AND NOTARIAL SEAL.


REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, EDUARDO M. VILLAR, of legal age, Filipino, and a resident of Kalikid


Norte, Cabanatuan City, after having been sworn to in accordance with
law, hereby depose and state:

32. That I am a depositor of China Banking Corporation in Maharlika


Highway, Cabanatuan City with account no. 2640690412;

33. That as a depositor of China Bank, I am a holder of China Bank ATM


card;

34. That due to unavoidable circumstances, my ATM card was lost and
despite my diligent search, I can no longer locate the same; and

35. That I am executing this affidavit to support my request with the China
Bank for the reissuance of a new ATM card to replace my lost ATM card.

IN WITNESS WHEREOF, I have hereunto set my signature this____ day


of _______________________at Cabanatuan City.

EDUARDO M. VILLAR
Affiant

SUBSCRIBED AND SWORN to before me at the place and date above


stated. I hereby certify that I personally examined the affiant and am
convinced that he voluntarily executed the foregoing affidavit, read the same
and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.


REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, IMEE ERNIE CABRERA, of legal age, Filipino, and a resident of Amihan,


Barrera, Cabanatuan City, after having been sworn to in accordance
with law, hereby depose and state:

36. That I am an employee of NE Cake Restaurant in NE Crossing,


Cabanatuan City;

37. That as an employee of NE Cake Restaurant, I receive regularly my


salary thru the Robinson ATM payroll system;

38. That on May 10, 2013, I discovered that my Robinson ATM card was
lost and despite my diligent search, I can no longer locate the same;
and

39. That I am executing this affidavit to support my request with the


Robinson Bank for the reissuance of a new ATM card to replace my lost
ATM card.

IN WITNESS WHEREOF, I have hereunto set my signature this ______day


of _____________________ at Cabanatuan City.

IMEE ERNIE CABRERA


Affiant

SUBSCRIBED AND SWORN to before me at the place and date above


stated. I hereby certify that I personally examined the affiant and am
convinced that he voluntarily executed the foregoing affidavit, read the same
and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.


LostATM2

REPUBLIC OF THE PHILIPPINES )


CITY OF CABANATUAN ) S.S.

AFFIDAVIT OF LOSS

I, NOEL CALMA PUNAY, of legal age, Filipino, and a resident of 315


Rodriguez St., Aduas Sur, Cabanatuan City, after having been sworn to
in accordance with law, hereby depose and state:

40. That I am an employee of Wesleyan University-Philippines, Cabanatuan


City;

41. That as an employee at Wesleyan University-Philippines, Cabanatuan


City, I receive regularly my salary thru the China Bank ATM payroll
system;

42. That as a depositor of China Bank, I am a holder of China Bank ATM


card;

43. That on August 28, 2009, I discovered that my ATM card was lost and
despite my diligent search, I can no longer locate the same; and

44. That I am executing this affidavit to support my request with the China
Bank for the reissuance of a new ATM card to replace my lost ATM card.

IN WITNESS WHEREOF, I have hereunto set my signature this 1 st day of


September, 2009 at Cabanatuan City.

NOEL CALMA PUNAY


Affiant

SUBSCRIBED AND SWORN to before me at the place and date above


stated. I hereby certify that I personally examined the affiant and am
convinced that he voluntarily executed the foregoing affidavit, read the same
and understood its contents.

WITNESS MY HAND AND NOTARIAL SEAL.


LostATM2

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