Repulic of the Philipines)

City of ____________) S.S

AFFIDAVIT OF LOSS

I, Leah C. Cruz of legl age, Filipino, Married and with office address at 36 Paulo St., Gabriel II
Sud., Malabon City, Metro Manila after having been duly sworn to in accordance with law, do hereby
depose and say.
1. That I am the Owner of the following vessels which is particularly described as follows:
Vessel Name
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:
:

MBca. SAMPAGUITA DOS

00-0001212
0050538
0050539
16.18

Vessel Name
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:
:

MB BAGONG SILANG DOS

00-0001195
0037978
0037979
18.10

2. That as the owner, I supervised the keeping and maintenance of the records of the said vessels.
3. That I hereby certify that original copy of the Certificate of Ownership and Certificate of
Philippine Registry of the vessels mentioned above was inadvertenly lost and cannot be located
despite diligent efforts to locate it.
4. That I am executing this affidavit to attest to the truth of the foregoing in relation to our
application for replacement of the Certificate of Ownership and Certificate of Philipinne Registry
from the Maritime Industry Authority (MARINA).
5. That the vessel is free from all liens and encumbrances:

IN WITNESS WHEREOF, I have set my hand at City of Manila, Philipines this _________
day of ________________ 2016.

LEAH C. CRUZ
Affiant
SUBSCRIBED AND SWORN to before me this __________ day of
___________________________ 2016 at __________________________, Philippines affiant
exhibiting to me his _________________________________ at
_________________________________,

NOTARY PUBLIC
Doc. No. _________.
Page No. _________.
Book No. _________.
Series of 2016

Repulic of the Philipines)

City of ____________) S.S

AFFIDAVIT OF LOSS

I, Marycel C. Cruz of legl age, Filipino, Married and with office address at 36 Paulo St., Gabriel
II Sud., Malabon City, Metro Manila after having been duly sworn to in accordance with law, do hereby
depose and say.
6. That I am the Owner of the MBca. SOMEWHERE DOS which is particularly described as
follows:
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:

00-0001213
0038030
0038031
17.43

7. That as the owner, I supervised the keeping and maintenance of the records of the said vessels.
8. That I hereby certify that original copy of the Certificate of Ownership and Certificate of
Philippine Registry of the vessels mentioned above was inadvertenly lost and cannot be located
despite diligent efforts to locate it.
9. That I am executing this affidavit to attest to the truth of the foregoing in relation to our
application for replacement of the Certificate of Ownership and Certificate of Philipinne Registry
from the Maritime Industry Authority (MARINA).
10. That the vessel is free from all liens and encumbrances:

IN WITNESS WHEREOF, I have set my hand at City of Manila, Philipines this _________
day of ________________ 2016.

MARYCEL C. CRUZ
Affiant
SUBSCRIBED AND SWORN to before me this __________ day of
___________________________ 2016 at __________________________, Philippines affiant
exhibiting to me his _________________________________ at
_________________________________,

NOTARY PUBLIC
Doc. No. _________.
Page No. _________.
Book No. _________.
Series of 2016

Repulic of the Philipines)

City of ____________) S.S

AFFIDAVIT OF LOSS

I, Gina C. Cruz of legl age, Filipino, Married and with office address at 36 Paulo St., Gabriel II
Sud., Malabon City, Metro Manila after having been duly sworn to in accordance with law, do hereby
depose and say.
1. That I am the Owne of the MB KAIBIGAN DOS which is particularly described s follows:
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:

00-0001210
0038028
0038029
27.76

2. That as the owner, I supervised the keeping and maintenance of the records of the said vessels.
3. That I hereby certify that original copy of the Certificate of Ownership and Certificate of
Philippine Registry of the vessels mentioned above was inadvertenly lost and cannot be located
despite diligent efforts to locate it.
4. That I am executing this affidavit to attest to the truth of the foregoing in relation to our
application for replacement of the Certificate of Ownership and Certificate of Philipinne Registry
from the Maritime Industry Authority (MARINA).
5. That the vessel is free from all liens and encumbrances:

IN WITNESS WHEREOF, I have set my hand at City of Manila, Philipines this _________
day of ________________ 2016.

GINA C. CRUZ
Affiant
SUBSCRIBED AND SWORN to before me this __________ day of
___________________________ 2016 at __________________________, Philippines affiant
exhibiting to me his _________________________________ at
_________________________________,

NOTARY PUBLIC
Doc. No. _________.
Page No. _________.
Book No. _________.
Series of 2016

Repulic of the Philipines)

City of ____________) S.S

AFFIDAVIT OF LOSS
I, Alberto C. Cruz of legl age, Filipino, Married and with office address at 36 Paulo St., Gabriel
II Sud., Malabon City, Metro Manila after having been duly sworn to in accordance with law, do hereby
depose and say.
1. That I am the Owne of the following vessels which is particularly described s follows:
Vessel Name
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:
:

MBca. ANAK DAGAT DOS

00-0001198
0037984
0037985
17.98

Vessel Name
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:
:

MB BEAUTIFUL DOS
00-0000261
0026906
0026905
17.97

Vessel Name
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:
:

MB SUPERSTAR DOS
00-0001541
0039010
0039064
21.33

Vessel Name
Offiial No.
Certificate of Ownership Reg No.
Certificate of Philippine Reg No.
Gross Tonnage

:
:
:
:
:

MB ILANG ILANG DOS

00-0001211
0038341
0038342
17.62

2. That as the owner, I supervised the keeping and maintenance of the records of the said vessels.
3. That I hereby certify that original copy of the Certificate of Ownership and Certificate of
Philippine Registry of the vessels mentioned above was inadvertenly lost and cannot be located
despite diligent efforts to locate it.
4. That I am executing this affidavit to attest to the truth of the foregoing in relation to our
application for replacement of the Certificate of Ownership and Certificate of Philipinne Registry
from the Maritime Industry Authority (MARINA).
5. That the vessel is free from all liens and encumbrances:
IN WITNESS WHEREOF, I have set my hand at City of Manila, Philipines this _________
day of ________________ 2016.
ALBERTO C. CRUZ
Affiant
SUBSCRIBED AND SWORN to before me this __________ day of
___________________________ 2016 at __________________________, Philippines affiant
exhibiting to me his _________________________________ at
_________________________________,
NOTARY PUBLIC
Doc. No. _________.
Page No. _________.
Book No. _________.
Series of 2016