Republic of the Philippines)

C I T Y O F D A V A O ) SS.
x- - - - - - - - - - - - - - - - - --x

AFFIDAVIT OF LOSS

I, WAHAB A. MAMBUAY, married, Filipino, of legal age, and a resident

of Tigatto, Davao City, after being duly sworn to in accordance with law do
hereby depose and say that:

1. I am the owner and possessor of a pawn ticket No. 50405SG

2. 014497 and No. 50402SG014661 issued by Cebuana Lhuiller, Davao
Bolton branch.

3. On or around May 6, 2018, I inadvertently misplaced the aforestated

pawn tickets;

4. Notwithstanding diligent efforts exerted to find them, the same were

not found, recovered, or located, hence, considered lost and
destroyed for all intents and purposes;

5. I am executing this affidavit without any fraud or intent to deceive on

my part and I forever free any person from any liability that may arise
from this circumstance, and/or any entity, be it governmental or
private;

6. I am therefore executing this affidavit to attest to the truth of all the

foregoing and to apprise any person, natural and juridical,
governmental or private of such fact of loss and for all other legal
purposes this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_____________at Davao City, Philippines.

WAHAB A. MAMBUAY
Affiant
TIN-941-925-437

SUBSCRIBED and SWORN to before me, in the City of Davao, this

_______________, affiant exhibiting to me his/her competent evidence of
identity first written above below his/her name.

Doc No.________
Page No.________
Book No.________
Series of 2018.