Republic of the Philippines )

Province of Cagayan )
Municipality of Alcala ) S.S.

AFFIDAVIT OF LOSS PAWNTICKET

I, LADY PEARL CUDAL, Filipino, of legal age, and a resident of

Baybayog, Alcala, Cagayan, after being duly sworn in accordance with law,
depose and state:

1. That I pawned my laptop with TABUNTING PAWNSHOP and for which I

was issued a Pawn Ticket with the following details:

Papeleta: 2539
Amount: Php3,000
Item Description: Iphone 7plus without charger def.
Date pawned: April 22, 2023

2. That I found out that the said Pawn Ticket was missing from among
my belongings.
3. That despite diligent search and efforts to locate the said pawn ticket,
I could not find the same such that I now believe that it is lost beyond
recovery.
4. As such, I am executing this Affidavit of Loss to attest to the
truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hand this 26 th day of May

2023 at Alcala, Cagayan, Philippines.

LADY PEARL CUDAL

Affiant

SUBSCRIBED AND SWORN to before me this 26th day of May 2023 at Alcala,
Cagayan, Philippines.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2023.