REPUBLIC OF THE PHILIPPINES)

CITY OF ORMOC )S.S.

AFFIDAVIT OF LOSS

I, ROSITA RAMOS, of legal age, Filipino and a resident of Ormoc City, Leyte,
Philippines, after having been duly sworn to in accordance with law do hereby depose
and say that;

1. That I am a secretary of ----------- a duly organized and existing under

the Philippine laws with address at Cebu City, Philippines with an
office address at Brgy. Punta, Ormoc City, Leyte;

2.

3. The above-mentioned load sheet and bill of lading got misplaced

and beyond recovery and now it considered lost;

4. That I am executing this affidavit in order to attest the fact of loss and
for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of ________

in Ormoc City, Philippines.

ROSITA RAMOS
Affiant
Valid ID:________

SUBSCRIBED AND SWORN TO before me this __ day of _________ in Ormoc City,

Philippines.