REPUBLIC OF THE PHILIPPINES )

DASMARIÑAS CITY, CAVITE ) S.S.

AFFIDAVIT OF LOSS
I, JOCELYN CANAPI JILAH, of legal age, Filipino Citizen, married and with postal
and residence address at Salitran I, Dasmariñas Cavite, after having been duly sworn to in
accordance with law, hereby depose and say:

That I am registered owner of CEBUANA 24k PLUS Card issued by Cebuana

Lhuillier located at Salitran I, Dasmariñas City, Cavite, Philippines, duly registered
under Philippine Law;

That the said Cebuana 24k plus card was lost while I am buying some groceries last July
2023 and never been found;

That I hereby attest and testify that the said Cebuana 24k plus card was not encumbered
or pledged in any person, or financial institution here in the Philippines;

That despite of diligent efforts, the application for the said Cebuana 24k plus card cannot
be found and it was considered as lost;

That I am executing this affidavit to attest to the truth of the foregoing facts for all legal
intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this 14th day of August 2023 at
Dasmariñas City, Cavite, Philippines.

JOCELYN CANAPI JILAH

Affiant

SUBSCRIBED and SWORN to before me on the date and place above-written.

Affiant exhibiting his PRC ID no: 1110057.

Doc. No. 460

Page No. 92
Book No. 15
Series of 2023