Republic 

of the Philippines)
Province of__________________) S.S.
City/Municipality of_____________)
x-----------x

AFFIDAVIT OF LOSS

I,RIZA P. CINCO, Filipino, of legal age, married, and a resident of Purok honda Bay,

Bgy. Sta Lourdes, Puerto Princesa City, Philippines, after being duly sworn in
accordance with law, depose and state:

1. I am the owner of DON JAY-AR STORE with business address at Purok honda
Bay, Bgy. Sta Lourdes, Puerto Princesa City;
2. On December 17, 2021, due to torrential rains brought by “Bagyong Odette”, our
store was submerged in floodwaters and various documents were flooded;
4. Sales Invoices, Collection Receipts, Books of Accounts and other documents
and records in connection with our sales transactions and purchases transactions were
destroyed and/or lost;
5. Diligent efforts were exerted to retrieve or locate the aforesaid documents and
records but to no avail. I have reason to believe that these items are permanently lost;
6. Due to said loss, I will not be able to comply with the documentary requirements of
the Business Permits and Licensing Office of the City of Parañaque in connection with
my request for business retirement of ABC Bookstore and General Merchandise-
Branch;
7. I am executing this affidavit to attest to the truthfulness of the foregoing
statements and for whatever legal purpose this may serve best.
IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of
________________ at Parañaque City, Philippines.