REPUBLIC OF THE PHILIPPINES ) _______________________________ )S.S.

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AFFIDAVIT OF LOSS I, JENIFER E. DAVID, Filipino, of legal age, married with address at Blk 49 21st St. Lot 27 Ph 2 Madapdap Resettlement, Mabalacat, Pampanga, Philippines, after having duly sworn to in accordance with law, hereby depose and say that: 1. I am a holder of a Drivers License issued by the Land Transportation Office; ATM Cards issued by Banco De Oro, Metrobank and Bank of Philippine Islands; credit card issued by Hongkong Shanghai Banking Corporation; and pawn ticket issued by F.L.A. pawnshop; 2. I lost said Drivers License, ATM Cards, Credit Card and pawn ticket on 27 February 2010 at around 4:30 in the afternoon and that I exerted all efforts to locate the same but to no avail and it is considered lost for all legal purposes; 3. Said cards and documents were lost because the wallet wherein they were placed was pick-pocketed on the date above given at Puregold Dau Mabalacat, Pampanga and said incident was duly reported to the authorities; 4. Said Cards and documents were not confiscated by any officer of the law or their issuer by reason of any violation of any law, ordinance, presidential decree or rules and regulation; and neither was it offered as collateral for any loan; 5. I am executing this affidavit to attest to the foregoing facts. IN WITNESS WHEREOF, I have hereunto set my hand this ______________ in the City of _____________________, Philippines.

JENIFER DAVID Affiant SUBSCRIBED AND SWORN to before me this _______________ in the City of __________, Philippines, affiant having exhibited to me her community tax certificate with no. __________________ issued on _________________ at ______________ and ________________________________ issued by ______________________________.

Notary Public Doc. No. ________; Page No. ________; Book No.________; Series of 2010.