Republic of the Philippines)

City of Butuan ) S.S.

AFFIDAVIT OF LOSS

I, DARLING B. BOCTOT, of legal age, Filipino, married and a resident of

Purok -6, Barangay Bitan-agan, Butuan City, under oath, depose and state THAT:

1. I am the owner/ holder of a Tax Identification no. 345-783-615.

2. Recently, I discovered that my documents were lost and can no

longer be found despite diligent efforts to locate the same;

3. I am executing this affidavit to attest to the veracity of the

foregoing and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

___________________ at Butuan City, Philippines.

DARLING B. BOCTOT
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this

____________________ at Butuan City, Philippines.

Doc. No. ________;

Page No. ________;
Book No. _______ ;
Series of 2023