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Republic of the Philippines )

City of Tacloban ) S.S.

AFFIDAVIT OF LOSS

I, TERESITA O. GARCIA, Filipino, of legal age, married, and with


residence at Brgy. 59, Picas, Sagkahan, Tacloban City, Philippines, after
being duly sworn to in accordance with law, hereby depose and state:

1. That I am a stockholder of Card Bank, Inc. and was issued a


Stockholder’s Certificate;

2. That on November 8, 2013, said Stockholder’s Certificate was lost


and destroyed during the typhoon Yolanda;

3. That despite diligent search and efforts to locate said Stockholder’s


Certificate, I could not find the same such that I now believe that it
is now lost beyond recovery;

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


truth of the foregoing statements and for whatever purpose it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this


_____________ at _____________, Philippines.

TERESITA O. GARCIA
Affiant

SUBSCRIBED and SWORN TO before me this at


Tacloban City, affiant exhibiting to me her issued on
as competent evidence of identity.

WITNESS MY HAND AND SEAL on the date and place stated above.

Doc. No. _____;


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

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