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Republic of the Philippines ]

City of Valencia ] s.s.

AFFIDAVIT OF LOSS

I, MAY ANN CALVA, Filipino, of legal age, single and with office address
at Valencia Cable TV Network, Inc., Poblacion, Valencia City, Bukidnon after
having been duly sworn to in accordance with law, depose and state, that:

1. I am an employee of Valencia Cable TV Network, Inc.;

2. Lately, I discovered that the Official Receipt (OR) of the vehicle in the
name of VALENCIA CABLE TV NETWORK, INC. is missing from our records
and despite our diligent effort to locate the same, the Official Receipt can no
longer be located and considered as lost and destroyed;

3. The said vehicle is particularly described as follows: Make Hyundaii


dropside; Engine No. 4D56-CD5325; Chassis No. KMFF17XBLU-131925; Color:
Blue;

4. The said Official Receipt was not sold or transferred to any third person
and neither was it confiscated nor forfeited in favor of any government agency;

5. I am executing this affidavit to attest to the truth of the foregoing facts


and to establish the loss of the aforesaid Official Receipt.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ th


day of May 2005 at Valencia City, Bukidnon, Philippines.

MAY ANN CALVA


Affiant

SUBSCRIBED AND SWORN to before me this ____th day of May 2005 at


Valencia City, Bukidnon, Philippines, affiant exhibiting to me his Community Tax
Certificate No. 04933167 issued on 08-11-05 at Valencia City.

Doc. No. _____:


Page No. _____:
Book No. _____;
Series of 2005.

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