That I further declare that the said described vehicle is free from liens
and/or encumbrances and shall defend its ownership from any /all
claims/whatsoever.
IN WITNESS WHEREOF, I have hereunto set my hands this 9th day of March
2019 in the Municipality of Minglanilla, Cebu, Philippines.
DOMINADOR B. HERMOSORA
VENDOR
DRIVERS LIC. NO. G0182004566
Issued on November 13, 2016
At Talisay Extension Office, Talisay
City, Cebu
ACKNOWLEDGMENT
AFFIDAVIT OF LOSS
Doc No._________;
Page No.________;
Book No.________;
Seri es of ________.