REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI )S.S

AFFIDAVIT OF LOSS

I, FENG WENLI, of legal age, and with residence address at 1506 Gramercy
Residence, Makati City, After having been duly sworn to in accordance with law, do
hereby depose and state:

That I am the holder of a Proximity Card;

That the said Proximity Card was loss due to unavoidable circumstances when
it was unfortunately misplaced;

That despite of diligent effort that has been made to look for the same, it
cannot be found and therefore considered lost for all intents and purposes;

That I am executing this affidavit to attest to the truth of the foregoing facts
and for the information and guidance of the proper authorities concern and to
facilitate my affidavit of loss to mentioned above and for whatever legal purposes
and intents it may do serve.

FURTHER AFFIANT SAYETH NAUGHT

IN WITNESS WHEREOF, I have hereunto affixed my signature this 3 rd day of

September 2021 at the City of Makati.

FENG WENLI
Affiant

Subscribed and sworn to before me this 3rd day of September 2021 at the City
of Makati, and affiant exhibiting to me his _______________________________.

Doc No:______
Page No:______
Book No:_______
Series of 2021