REPUBLIC OF THE PHILIPPINES)
Province of Zamboanga Sibugay ) SS.
MUNICIPALITY OF BUUG )
AFFIDAVIT OF LOSS
I, WALTER RAY BALLESTA GASCON, of legal age and with postal address at Purok 7,
Barangay Poblacion, Buug, ZSP, under oath, state:
1. THAT, on the month of June at the residence of my parents while I turned over to my mother,
Mrs. Chona Ballesta Gascon a Lorenzo Tan Multi-purpose Cooperative (LTMPC) passbook;
2. THAT, when I was asked my mother on the LTMPC Passbook so I could make a deposit, it
was not found;
3. THAT, I and my mother exerted diligent efforts to locate the LTMPC Passbook, but was not
able to locate the LTMPC Passbook and I therefore considered the same as lost and can no longer be
found;
4. THAT I am executing this Affidavit to attest to the truth of the foregoing facts and to use the
same for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I hereunto affix my signature this 9th day of September 2022.
CHONA B. GASCON WALTER RAY B. GASCON
Affiant Affiant
Attested by:
DOMINADOR P. SUMPO
Punong Barangay
Barangay Datu Panas