REPUBLIC OF THE PHILIPPINES )

PROVINCE OF LAGUNA ) S.S.

CITY OF BIÑAN )

AFFIDAVIT OF LOSS
I, TAGUMPAY B. ALILURAN II, of legal age, married, Filipino
citizen, with residential address at Block 5, Lot 3, Via F. Ferenze St.,
Romanville, Tagapo, City of Santa Rosa, Laguna, after having been
duly sworn to in accordance with law, hereby depose and state the
following:

1. That I am the holder of OFFICIAL RECIEPT and

CERTIFICATE OF RELEASE OF E-BIKE Issued by KENWEY
at Genaral Mariano Alavares, Cavite;

2. That on February, 2022, that the said OFFICIAL RECIEPT

and CERTIFICATE OF RELEASE OF E-BIKE, was misplaced
and lost without my prior awareness;

3. Efforts were exerted to locate the said OFFICIAL RECIEPT and

CERTIFICATE OF RELEASE OF E-BIKE , but in spite of
diligent search, it could not be found and the same is now
beyond recovery;
4. As such, I am executing this Affidavit of Loss to attest to the
truth of the foregoing and to support my application for the E-
Bike registration.
IN WITNESS WHEREOF, I have hereunto affixed my signature
herein below this 25th day of January 2024, at the City of Biñan,
Laguna.

TAGUMPAY B. ALILURAN II
Affiant

SUBSCRIBED AND SWORN TO before me this 25th day of

January 2024, affiant to me his UMID ID. with No. 0111-0549193-1
as his Competent Evidence of Identity.

WITNESS MY HAND AND SEAL on the date and at

the place first above written.

Doc. No.186
Page No.38
Book No. I
Series of 2024