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![Page 1: For card replacement due to lost SS digitized ID or IJMID Card Duly notarized Affidavit of Loss [2 Proof of payment For card replacement due to non-receipt of UMID Card C] Duly notarized](https://reader042.cupdf.com/reader042/viewer/2022040506/5e4062489ca36925136e6519/html5/page/1.jpg)
![Page 2: For card replacement due to lost SS digitized ID or IJMID Card Duly notarized Affidavit of Loss [2 Proof of payment For card replacement due to non-receipt of UMID Card C] Duly notarized](https://reader042.cupdf.com/reader042/viewer/2022040506/5e4062489ca36925136e6519/html5/page/2.jpg)
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