REPUBLIC OF THE PHILIPPINES)

BACOLOD, LANAO DEL NORTE) S.S.

AFFIDAVIT

I, LUDYFREDA L. COGO, of legal age, married, Filipino citizen and

residing at Purok 5, Poblacion, Bacolod Lanao del Norte after having been
sworn in accordance with law hereby depose and state:

1. I am the proprietor of Kim and Sheen Store, registered under existing

laws with principal address at Purok 3, Poblacion, Bacolod, Lanao del
Norte;
2. That sometime on February 9, 2018 at around 10 o'clock in the evening,
a big fire broke out in the Public Market which caused the whole public
market, including our store completely destroyed damaged, spoiled all of
the assorted stocks and merchandise stored in the said area;
3. That the said fire was controlled and put off only about 6 hours later by
the efforts of the different fire brigades which responded to our call for
assistance;
4. That I am executing this affidavit to attest to the truth and veracity of
the foregoing facts of my own personal knowledge and belief and to
attest to the said fact of lost due to the fire that gutted our Municipal
Public Market last February 9, 2018 at around 10:40 in the evening,
practically reduced to ashes.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day March 2018
at Bacolod, Lanao del Norte.

LUDYFREDA L. COGO
Affiant
Competent Proof of Identity
TIN No. 114-781-181-000 Bacolod, Lanao del Norte

SUBSCRIBED AND SWORN TO before me, this 7th day March

2018 at Bacolod, Lanao del Norte, with affiant having exhibited to me her
competent proof of identity.

ATTY. ALFONS JANSSEN P. MARCERA

Notary Public
Serial No. 17-152
Iligan City- Lanao del Norte
Until December 31, 2018
IBP Lifetime No. 01840
Doc. No. : ________; Roll No. 70427- July 31, 2017
Page No. : ________; PTR No. 3520052-12/31/18
Book No. : 2; IBP No. 021317-01/31/18
Series of 2018. MCLE 2016 Bar Passer