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AFFIDAVIT OF LOSS
I, ROSANIE F. ESTUCHE, of legal age, single/married, Filipino, with postal address at #2 Cadena de Amor St., Higgins, Pasay City, after having duly sworn to in accordance with law, hereby depose and state: 1. That I am a holder/bearer of a pawnshop paper or document (Papel de Agencia) issued by Ochoa Realica Pawnshop; 2. That I lost said pawnshop paper last October 5, 2013 while I was on my way home; 3. That I exerted so much effort to recover the same but it was to no avail; 4.That I executed this affidavit to attest the truth hereof, and for the purpose of securing a new one in lieu thereof. IN WITNESS WHEREOF, I have hereunto affixed my hand this 24th day of January, 2014 in Pasay City, Philippines.
SUBSCRIBED AND SWORN to before me on the day, month, year, place above-written. Affiant exhibited to me her Comm. Tax Cert. No. 31306288 issued at Pasay City on January __, 2014.
NOTARY PUBLIC Doc. No. ____; Book No. ____; Page No. ____; and Series of 2014.