REPUBLIC OF THE PHILIPPINES)

DAVAO CITY )SS.

x---------------------------------------------x

AFFIDAVIT OF LOSS

I, JOVITO ALBANO ONG, of legal age, single, and a resident of Davao City,
after being sworn in accordance with law hereby depose and say that:

1. I am the holder of a pawn ticket issued by CEBUANA LHUILLER

PAWNSHOP located at Matina Crossing, Davao City, with PT No.
60227SG028742;

2. The aforesaid pawn paper was among my effects until sometime in the
month of July 2018 when I noticed it was already missing from its usual
place.

3. Notwithstanding diligent efforts exerted to find it, the same was not found,
recovered, or located, hence, considered lost and destroyed for all intents
and purposes.

4. I am therefore executing this affidavit to attest to the truth of all the

foregoing and to apprise CEBUANA LHUILLIER of such fact of loss, and
for all other legal purposes this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

__________________, in the City of Davao, Philippines.

JOVITO ALBANO ONG

Affiant
CRN-0003-2136567-3
SUBSCRIBED and sworn to before me, in the City of Davao, this
________________, affiant exhibiting to me his/her competent evidence of identity
first written above below his/her name.

Doc No.________
Page No.________
Book No.________
Series of 2018.