REPUBLIC OF THE PHILIPPINES)

CITY OF BATANGAS ) S.S.

AFFIDAVIT OF LOSS
I, xxx, of legal age, Filipino, and with business
address at Poblacion Mabini, Batangas, after having been
duly sworn to in accordance with law, hereby depose and
states:

That I am a holder of a Certificate of Registration duly

issued by the Bureau of Internal Revenue;

That sometime on May, 2016, the said BIR Certificate

of Registration appeared to have been lost or misplaced;

That I exerted diligent efforts to find and locate the

said BIR Certificate of Registration but the same proved
futile;

That I am executing this affidavit to attest to the

truth of all the foregoing facts and to inform the proper
authorities of the loss of the said BIR Certificate of
Registration, and for whatever legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand

this 18th day of May 2016 at Batangas City, Philippines.

xxx
Affiant
 SUBSCRIBED AND SWORN to before me this 18th
day of May 2018 at Batangas City, Philippines.