Republic 

of the Philippines )
City of __________ ) S.S.
x----------------- x

AFFIDAVIT OF LOSS

I, __________, Filipino, of legal age, married, and a resident of

__________, Philippines, after being duly sworn in accordance with law,
depose and state:

1. That I am the Owner of __________, a corporation duly

organized and existing under and by virtue of the laws of the
Republic of the Philippines.
2. That being registered with the Bureau of Internal Revenue,
__________ has been issued a BIR Certificate of Registration;
3. That sometime last month, the original copy of the said BIR
Certificate of Registration could not be found and that
despite diligent search and efforts, the same could no longer be
found such that I 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 and for whatever legal purposes that this
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of

__________ 2020 in the City of __________, Philippines.

_______________
Affiant

SUBSCRIBED AND SWORN to before me this ___ day of _______ at

_______________. I HEREBY CERTIFY that I have personally examined
the herein affiant and I am satisfied that he voluntarily executed and
understood his given affidavit.

_____________________
Notary Public