REPUBLIC OF THE PHILIPPINES)

Binan City, Laguna ) S.S.

AFFIDAVIT OF LOSS

I, SHERWIN R. LORENZO, Filipino, of legal age, and with office address at

Gardenia Centre, Star Avenue, Laguna International Industrial Park (LIIP), Mamplasan,
Binan Laguna, subscribing under oath, depose and state that:

1. I am the Assistant Logistics Manager of Gardenia Bakeries Philippines, Inc.;

2. The following receipts for reimbursement in the total amount of ELEVEN

THOUSAND THREE HUNDRED SIXTY EIGHT PESOS (Php 11,368.00) was
received by Trizia Ellaine Espinili and Mr. Alvin Anore on the dates stated
below:

DATE ENTITY RECEIPT/O.R. No. Amount in Pesos

8/16/2020 Philippine Postal Corporation 52
8/11/2020 South Luzon Tollway Corp 2554156 47
8/11/2020 South Luzon Tollway Corp 928987 25
8/11/2020 South Luzon Tollway Corp 2444491 47
8/12/2020 South Luzon Tollway Corp 2446544 47
8/12/2020 Fortunewell Inc. F 000-SI014726 1000
8/16/2020 Firstline Fuel Trading F 000-SI216549 500
8/20/2020 Fortunewell Inc. F 000-SI14446 700
8/25/2020 Big Joe Gas Station F 000-SI535618 500
8/22/2020 Gercon Shell Station F 000-SI435653 300
8/22/2020 Fortunewell Inc. F 000-SI24469 1500
8/31/2020 GLC Shell Motorist's Point F 000-SI766065 1000
9/2/2020 I-Serve 360 Corp. F 000-SI461758 1050
9/20/2020 GLC Shell Motorist's Point F 000- SI54196 1000
9/9/2020 John Igleasi Jr. Shell Service Station F 000-SI419276 1000
9/14/2020 Jem Petron Service Station 930905 100
9/15/2020 Jem Petron Service Station 931049 1000
9/16/2020 SLT Gasmart Corporation F 000-SI031880 500
9/24/2020 Fortunewell Inc. F 000-SI045410 1000

3. I ordered Mr. Alvin Anore to deliver said receipts together with my expense
report to my boss, Mr. Nestor E. Constancia, who residing at Quezon City;

4. That I have learned that said receipts under the custody of Mr. Alvin Anore
was lost in transit while being delivered to Mr. Nestor E. Constancia’s
residence;

5. That despite diligent efforts exerted, the above stated receipts can no longer
be found or recovered and that to the best of my knowledge are truly lost;

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

foregoing and for any legal purpose this may serve.
 IN WITNESS WHEREOF, we have hereunto set our signature this ___ day of
_______2021, at Binan City, Laguna.

SHERWIN R. LORENZO
Affiant

SUBSCRIBED AND AWORN to before me this _ day of _______ 2021 at Binan

City Laguna, affiant exhibiting to me her Driver’s License with ID. No. D04-98-127205.

IN WITNESS WHEREOF, I have hereunto set my hand and seal on the above
stated date and place.

Doc No.____;
Page No.___;
Book No.___:
Series of 2021.