Republic of the Philippines ]

City of Tagbilaran ] S.S.

AFFIDAVIT OF LOSS

I, MA THERESA C. CABREROS, Filipino, of legal age, married and a resident of

Bagtik, Catigbian, Bohol, Philippines, after being duly sworn in accordance with law, hereby
depose and say:

1. That I am a holder of a Savings and Share Capital account with ORO INTEGRATED
COOPERATIVE, Tagbilaran City, Bohol, with account no. 11-02716-2 and 10-
03665-3 respectively;

2. That as such, I was issued a two passbook for the two accounts by the said
cooperative;

3. That said passbooks for the Savings and Share Capital Accounts was misplaced/lost
last July 12, 2020;

4. That I exerted diligent efforts to find and recover the aforesaid passbooks, however,
my efforts proved futile as until now, its whereabouts still could not be ascertained,
hence, I considered it to be lost for all intents and purposes;

5. That the said two passbooks were not transferred to any person for consideration or
used as collateral to secure obligations;

6. That I execute this affidavit voluntarily to attest to the truth of the foregoing
statements to support my request with ORO INTEGRATED COOPERATIVE for the
issuance of another passbook in lieu of the lost one;

7. That I hereby hold free and harmless the said cooperative for the issuance of another
passbook in my favor and I undertake to surrender with the cooperative the aforesaid
lost ORO INTEGRATED COOPERATIVE Passbook in case it is found later on;

8. That further, I execute this affidavit for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this 14th day of July 2020 at
Tagbilaran City, Bohol, Philippines.

MA THERESA C. CABREROS
Affiant
PRC ID No. 1156049
Professional Regulation Commission
Manila

SUBSCRIBED AND SWORN to before me this 14th day of July at Tagbilaran City,
Bohol, Philippines.

ATTY. RALP RYAN A. LAGURA, CPA

MAULAS & LAGURA Law Offices
G/F Castelcelo Building 2 Gallares St,
corner J.S. Torralba St, Tagbilaran City
NOTARY PUBLIC until December 31, 2020
NCS No. 2019-68; TIN 263-686-047-000
Roll No. 72594, June 17, 2019
IBP Membership No. 088674; June 7, 2019
PTR No. 7958107; CY 2020
For the City of Tagbilaran and Other Municipalities of Bohol