AFFIDAVIT OF LOSS

I, FLORENCIO P. AYERAS of legal age, Filipino, with business address at

No. 110 Old Bayanihan Street, Greenville Homes, Baesa, Caloocan City, after
having sworn in accordance with law, hereby depose and say:

1. That I am the Accountant of ______________________________, with

principal place of business at _______________________________________
________________________________________________________________.

2. That I am looking for the Original copy of Authority to Print with BIR
Autho. No. OCN-______________________ but I can’t find in our files;

3. That I exerted all efforts to look for the original copy but to know avail;

4. That I execute this affidavit to attest to the truth of the foregoing

statements for all legal intent it may duly serve

FURTHER AFFIANT SAYETH NAUGHT.

FLORENCIO P. AYERAS
Affiant

(REPUBLIC OF THE PHILIPPINES) s.s.

SUBSCRIBED AND SWORN to before me this ______day of __________2013,

affiant exhibiting to me his Tax Identification No. 100-570-805-000 Issued at
Quezon City.

Doc. No. _________

Page No. _________
Book No. _________
Series of 2016