REPUBLIC OF THE PHILIPPINES) CITY OF LAPU – LAPU ) S.S.

AFFIDAVIT OF LOSS

I, TRICIA JANE PHIL C. ENGCOY, Filipino, of legal age, single and a resident of Brgy. Mactan, Lapu–Lapu City, Philippines, after having duly sworn to in accordance with law, hereby depose and say that:

1. On April 24, 2013, Wednesday, I was cleaning the vicinity of the Bigfoot Building, One Hollywood Blvd., Bigfoot I.T and Media Park, Lapu–Lapu City; 2. While being busy with my work, I accidentally drop my Bigfoot identification card without realizing it; 3. With earnests search I was not able to find my Bigfoot identification card again; 4. I am executing this affidavit to attest to the foregoing facts, and for the purpose of re-issuance of a new Bigfoot identification card and for whatever legal purpose this may serve. IN WITNESS WHEREOF, I have hereunto set my hand this ____th day of _____________2013 in the City of Lapu–Lapu, Philippines.

________________________ Affiant

SUBSCRIBED AND SWORN to before me this ____th day of ________ in the City of Lapu–Lapu, Philippines, affiant having exhibited to me his ____________________ issued at ________________.

Doc. No. _____; Page No. _____; Book No. _____ ; Series of 2012