REPUBLIC OF THE PHILIPPINES SS

Done: La Trinidad, Benguet

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AFFIDAVIT OF LOSS
I, ALLEN P. FERNANDO, of legal age, Filipino, married, and residing at Sta. Maria,
Alfonso Lista, Ifugao, Philippines, having been duly sworn in accordance with law, hereby
depose and state:

1. That I am a police officer at Alfonso Lista Police Station. As a police officer, a firearm
was issued to me;

2. The firearm details are as follows:

Serial No. PNP37239

Kind: Glock 17 Pistol
Caliber: 9MM

3. That I regularly bring such firearm with me during my duty hour;

4. That sometime of March 12, 2017, we made a patrol around Sitio Erosion, Namnama,
Alfonso Lista, Ifugao through manually paddled wooden boat;

5. That during the said patrol, the boat suddenly tilted and we jumped into the water and
swim to the nearby shore;

6. After I regained my breath, I noticed that the said firearm is missing in the said area;

7. That despite diligent effort to locate the firearm, I was not able to find it;

8. That said firearm have not been canceled, revoked or captured due to any violation, to
secure any obligation, or delivered to any person or entity for any other reason
whatsoever; and

9. That I am executing this affidavit to attest to the foregoing facts and for any legal purpose
it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 28th day of September,
2020 in La Trinidad, Benguet, Philippines.

________________________________
ALLEN P. FERNANDO

SUBSCRIBED AND SWORN to before me, in La Trinidad, Benguet, this 28 th day of

September 2020 by ALLEN P. FERNANDO who has satisfactorily proven his identity to me
through his PNP ID with number 18K190185, that he is the same person who personally signed
the foregoing affidavit before me and acknowledged that he executed the same.

Doc. No. 251;

Page No. 52;
Book No. 3;
Series of 2020.