Republic of the Philippines ) S.S.

City of Davao )

AFFIDAVIT OF LOSS

I, ROLANDO IAN NAGAR DE VEYRA, Filipino citizen, of legal age and

presently residing at Magallanes Residence Valencia Building, Bolton
Extension, Barangay 1-a (Poblacion), Davao City after having been duly sworn to
in accordance with law, hereby depose and state:
1. That, I am an Owner of the business name “RIDNAR GENERAL
MERCHANDISE” which is registered with the Department of Trade and
Industry (DTI) pursuant to the provisions of Act 3883, as amended by Act
4147 and RA 863;

2. That I was issued a Certificate of Business Name Registration which is valid

from 27 December 2016 to 27 December 2021;

3. That recently, when we looked for the original copy of the said DTI Certificate
Business Registration, the same could not be found and must have been lost
and that despite of diligent search and efforts, the same could no longer be
found such that I now believe that it is lost beyond recovery;

4. That, I execute this affidavit to help support my request for renewal of my

business name registration before the DTI;

5. That, I execute this affidavit to attest to the truthfulness of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto signed my name below this 12th day
of October at Davao City.

ROLAND IAN NAGAR DE VEYRA

Affiant

SUBSRIBED AND SWORN to before me this 12TH day of October, at Davao City,
affiant exhibiting to me his Bureau of Internal Revenue ID No. 922-256-055-000.

Doc. No. : 130;

Page No.: 27;
Book No. : 1;
Series of : 2023