REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I,

KAMILLE D. RODRIGUEZ, of legal age, Filipino, single and resident of

Block 20 Lot 4, Casimiro Townhomes 3, Las Pinas City, after being duly sworn to in
accordance with law, hereby depose and say that:
1.

I am an employee of SLI Inc., with office address at 31 st Floor Burgundy

Tower, Pasong Tamo, Buendia, Makati City.

2.

As such, I a holder locker key issued by the company.

2. Said locker key inadvertently was lost.

3.

Inspite of diligent efforts to look for said

locker key, all such efforts

proved futile and in vain up to this time, thus, I am declaring the loss of
the said locker key.
4.

I am executing this affidavit to attest to the truth of the foregoing facts

and for all its legal intents, effects, consequences and purposes.

KAMILLE D. RODRIGUEZ
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this

Pias City.
Doc. No.

173

Page No.

36

Book No. 85
Series of 2014.

July 25, 2014 at Las