Republic of the Philippines )

City of Davao ) S.S.

AFFIDAVIT OF LOSS

I, MERACIE M. ACIERTO , single, of legal age, Filipino, and a resident of 171,

Sparrow St., Ecoland Ph2, Davao City after being duly sworn to in accordance
with law, do hereby depose and state;

1. That I am an owner of a Certificate of Time Deposit

issued by Bank of the Philippine Islands;

2. That I have lost and misplaced the said Certificate of Time

Deposit issued by Bank of the Philippine Islands;

3. That I have searched such Certificate of Time Deposit with

due diligence but have not found it;

4. That I declare that the same is lost and can never be found;

5. I am executing this Affidavit in good faith, for whatever legal

purpose it may serve and to attest to the veracity of the
foregoing;

IN WITNESS WHEREOF, I have hereunto set my hand this February 20,

2017 at Davao City, Philippines.

MERACIE M. ACIERTO
Affiant
Passport No. EB7049754

SUBSCRIBED AND SWORN TO before me, this February 20, 2017 at Davao
City, Philippines, affiant personally appeared to me.

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Series of 2017