Republic of the Philippines)

Quezon City ) S.S

AFFIDAVIT OF LOSS

That I, NOEL G. FRANCISCO, owner of QUINCO TRADING, and with residence

address at 11A ALLEY 17 ST., PROJECT 6, QUEZON CITY, after having been duly sworn
to in accordance with law, depose and state:

1. That I am the owner/holder of a DELIVERY RECEIPT WITH P.O No: MNL-

PO0000051599 and RECEIPT No: 0253;

2. The said DELIVERY RECEIPT, while in my possession were misplaced and could no
longer be located in spite of diligent efforts to locate them;

3. I shall assume responsibility or liability if in any event I will use these documents for
whatever illicit transactions;

4. am executing this affidavit to attest to the veracity of my statements.

IN WITNESS WHEREOF, I hereunto affix my signature this June 30th, 2022 at Quezon City.

NOEL G. FRANCISCO
Affiant

SUBSCRIBED AND SWORN to before me this June 30th, 2022 at Quezon City;

Doc No. ________;

Page No. ______ ;
Book No. _______;
Series of 2022