AFFIDAVIT OF LOSS

I, MARY ANNALYN J. MUNAR, of legal age, Filipino, single/married, and resident of 101 C. P. Rosales St.
Brgy. Sta. Ana, Pateros Metro Manila , after being duly sworn according to law, hereby depose and state
that:

1. I am the holder of the Official Receipt lost issued by Fort Bonifacio Development Corporation
payment for Security Deposit, Incidental fees and Marketing fees from the last event of National
Geographic Mars Activation Booth dated November 13, 2016 - November 19, 2016 with the following
check details: Banco de Oro Alfaro-Salcedo Village Branch, check number: 323065 amounting to Seventy
seven thousand eight hundred pesos (P77,800.00) issued by the BrandAction, Inc. last November 10,
2016 at BGC, Taguig.

2. Sometime in the month of November 2016, I lost the above Official Receipt issued by Fort Bonifacio
Development Corporation under the following circumstances:
We had the activation event for the whole week and we were just so busy, I unintentionally misplaced
the official receipt together with my other documents used for that event.

3. Despite diligent efforts exerted, I could no longer locate, find or recover the said Official Receipt, and
to the best of my knowledge, the same is truly lost.

4. The said Official Receipt has not been confiscated by any officer of the law or the issuing office or
agency due to the violation of any law, statute, order, rule or regulation.

5. In the event that the lost Official Receipt should hereafter be found or located, I undertake to forward
or surrender the same to Fort Bonifacio Development Corporation for appropriate disposal.

6. I am executing this Affidavit to attest to the truth of the foregoing statements and to request
the issuance of a new Official Receipt for BrandAction, Inc. in lieu of the one which was lost.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________________ at

_________________________.

Mary Annalyn J. Munar

Affiant

SUBSCRIBED AND SWORN to before me this ____________________, affiant exhibited to me

his/her Competent Evidence of Identity by way of __________________ issued at ______________ on
__________________.

Doc. No. ______;

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