REPUBLIC OF THE PHILIPPINES)

<CITY> ) SS.

AFFIDAVIT OF LOSS
I, <NAME>, of legal age, Filipino, <civil status>, residing at <residential address>, after having
been duly sworn to in accordance with law, do hereby depose and state:

1. I am the <position> of <CORPORATION> (the “CORPORATION”), a corporation duly

organized and existing by virtue of the laws of the Republic of the Philippines, with principal office
address at <office address>;

2. As such, I have access to the corporate documents of the CORPORATION;

3. I confirm that despite diligent search efforts, the <document> cannot be found among the
files of the CORPORATION;

4. I am executing this Affidavit to attest to the truth of the foregoing and for what every legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand ___________________ in <City>.

<NAME>

SUBCRIBED AND SWORN TO before me this <date> in <City>, affiant exhibiting to me his/her
<competent evidence of identity>.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2022. NOTARY PUBLIC