REPUBLIC OF THE PHILIPPINES)

ILOILO CITY )S.c.

x- - - - - - - - - - - - - - - -x

AFFIDAVIT OF LOSS
(Acknowledgement Receipt)

I, VINCENT D. BERMEJO, of legal age, Filipino, married and with

office address at Dr. 2 Willy Yap Warehouse Complex, Hinactacan, La Paz,
Iloilo city, after having been sworn to in accordance with law, hereby depose
and say, that:

1. I am a sales manager of Tacloban Winner Marketing Corporation

(TWMC), Iloilo Office;

2. Relative to my work, I keep and am entrusted with company

properties and certain documents including Acknowledgement Receipts;

3. Last July 22, 2020,I tried to look for the original copy of the following
Acknowledgement Receipt which I misplaced, to wit:

Acknowledgement Receipt No. Issued to Tacloban Winner Marketing Corp. - Company Total
Amount
1. June 16, 2020 A.R No. 000554 - Pacifica Agrivet Supplies, INC Php 52,450.50

4. After a thorough and diligent search for the original copy of the
above-described Acknowledgement Receipt, the same could no longer be
found and I now consider it all lost for all legal intents and purposes; and

5. I am executing this affidavit to attest to the truth of the foregoing

facts and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 12th

day of October 2020 in the city of Iloilo, Philippines.

VINCENT D. BERMEJO
Affiant

SUBSCRIBED AND SWORN to before me this _______________in

the city of Iloilo, Philippines, affiant exhibiting to me his Driver's License ID
No. F03-94-084202 as Competent Evidence of Identification.

Doc. No.: 504;

Page No.: 103;
Book No.: XXVI;
Series of 2020.