AFFIDAVIT OF LOSS  REPUBLIC OF THE PHILIPPINES)_____________________________ ) S.S.                                                      

 I, MARIA ANA A. MANUEL., Filipino, of legal age, residing at #4 Joshua Street Metro Gate Complex, Meycauayan, Bulacan, after having been sworn in accordance with law hereby depose and state: 

          That sometime in May of this year, I left my SSS ID with SSS No. 33-6084325-0 in the Emergency Room of St. Luke’s Hospital in Quezon City when I had my sick daughter checked           That when I got back to look for it, it was nowhere to be found           That I am executing this affidavit to attest to the truth of the foregoing and to request from the Social Security System Office of Meycauayan City, a new SSS ID.

 IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of October. 2009 at Meycauayan City.                                                                                                      MARIA ANA A. MANUEL                                            SUBSCRIBED AND SWORN to before me, this ____ day of ______________, 200___ in ___________________ City, with affiant exhibiting his CTC No. _______________ ,Issued on ______________________ at _________________________.                                                                                                 NOTARY PUBLIC                                                                                          Until December 31, 200___ Doc.  No. :  ________;Page  No. :  ________;Book No. :  ________;Series of 2009.