Republic of the Philippines)

City of Davao )s.s.

x - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF LOSS

I, JERICO BRYAN LUMBERA, of legal age, Filipino, and a resident of Purok

4, New Matina, Gravahan, Davao City, Philippines, after having duly sworn to in
accordance with law hereby depose and say:

That I am an employee of IBEX Global Philippines, SM Lanang, Davao City

That last December 20, 2016, I discovered that my wallet was lost;

That contained in the said wallet were my personal belongings including my

Company ID ;

That the same were not confiscated for violation of any law, rules and regulations;

That I am executing this affidavit to attest to the truth of the foregoing statements
and as a requirement for the issuance of a new company ID in lieu of the lost one and for
whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _________ day of

December, 2016, at Davao City, Philippines.

JERICO BRYAN LUMBERA

Affiant

SUBSCRIBED AND SWORN TO before me this _____________of December,

2016, at Davao City, Philippines, affiant exhibiting to me his ______________________.

Doc. No. ________

Page No. ________
Book No. _______
Series of 2016.