Republic of the Philippines)

City of Baguio . . . . . . . . . .) S.S.

AFFIDAVIT OF LOSS

I, CHARLIE B. BILAG, of legal age, married, Filipino citizen, PNP member and a
resident of BLK. 7, No. 6 East Quirino Hill, Baguio City, after having been duly sworn to
in accordance with law, hereby depose and state:

1. That I am the owner and possessor of that Toyota Tamaraw FX bearing Plate
Number AYA-475;

2. That at about 9 o’clock P.M of June 5, 2009, the front plate number of my said
vehicle fell/lost at Upper Pinget, Baguio City;

3. That I immediately exerted diligent efforts to locate the same but prove futile and I
now considered lost and beyond recovery;

4. That said plate number was not confiscated nor cancelled by the Land
Transportation Office or any law enforcement agency for violation of law, traffic
rules and regulations; and

5. That I am executing this Affidavit of Loss to attest to the truthfulness of the above
foregoing and to support my application for the replacement of my vehicle’s plate
number in lieu of the lost one.

IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of June,
2009 at Baguio City, Philippines.

CHARLIE B. BILAG
Affiant

SUBSCRIBED AND SWORN to before me this 15th day of June, 2009, by the
affiant who exhibited to me his Community Tax Certificate bearing number 15972002
issued on February 18, 2009 at Baguio City.

WITNESS MY HAND AND NOTARIAL SEAL.