Republic of the Philippines ) S.S.

City of )

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AFFIDAVIT OF LOSS FIREARM

I, MUHILMI T. ISMULA, Filipino, of legal age, married and a resident of KM. 2

Tanjung Road, Indanan, Sulu, Philippines, after being duly sworn in
accordance with law, depose and state:

That I am the true and licensed owner of a one (1) unit CAL 45 (RMTN)
firearm with Serial No. 1872921.

That sometime in 2003, the town of Jolo, Sulu was heavily flooded due to a
typhoon, thus some of my personal belongings were submerged in water
and were lost including the abovementioned firearm;

That despite diligent search and efforts to locate said firearm, I could not
find the same such that I now believe that the foregoing firearm is now
already lost beyond recovery.

As such, I am executing this Affidavit of Loss to attest to the truth of the

foregoing.

IN WITNESS WHEREOF, I have hereunto set my hand this day _____ day of
April 2019 at _________________________________, Philippines.

MUHILMI T. ISMULA

Affiant

SUBSCRIBED AND SWORN to before me, this _____ day of April 2019, by
MUHILMI T. ISMULA who exhibited to me his Driver’s License issued at
_______________________, Philippines on ________________________.

Notary Public

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2019;