[Republic of the Philippines ]

[City of Zamboanga ] S.S

X------------------]

AFFIDAVIT OF LOSS
I, ROGGIE MARK A. PASCO, of legal age, single, Filipino and a
resident of Sinunuc, Zamboanga City, after having been duly sworn to in
accordance with law, hereby depose and state, that:

I am a Development Officer of MEMPCO, Curuan branch;

I was issued a passbook by the MEMPCO bearing account number of which

I could no longer recall;

However, on March 17, 2017, Friday, I discovered that the said passbook
was missing in among my files and could no longer be found despite my
effort to locate the same, thus, I now consider the said passbook lost and
beyond the point of recovery; and

I am executing this affidavit to attest to the veracity of the foregoing facts

and for all legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 24 th day

of March 2017 in the City of Zamboanga, Philippines.

ROGGIE MARK A. PASCO

Affiant
MEMPCO ID Card No. 2013-0166

SUBSCRIBED AND SWORN to before me this 24th day of March

2017 in the City of Zamboanga, Philippines.

Doc. No. 500;

Page No. 100;
Book No. 123;
Series of 2017.