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AFFIDAVIT OF LOSS

I, E​ DGAR A. SULAIMAN​, of legal age, married to Nur-Aida B.


Sulaiman, Filipino citizen, with residence and postal address at
Taluksangay, Zamboanga City, Philippines, after having been duly
sworn to an oath in accordance with law, do hereby depose and say,
that:

1. I am the REGISTERED OWNER of one(1) unit Utility Vehicle,


registered with the Land Transportation Office, Zamboanga City,
Philippines, particularly described as follows:
Make : TOYO ACE ​Chassis No. : ​KM510062095
Body Type : ​DROPSIDE ​Plate No. : ​GTN568
Engine No. : 5K1281853 ​MV File No.. : ​0751-00000019427

2. On October 2017, I gave the said Certificate of Registration to


a certain “​HADJI ELING​”, for him to renew my registration with
the Land Transportation Office, Zamboanga City;

3. He had successfully renewed my registration but failed to


return the original copy of the the Certificate of
Registration;

4. Despite diligent efforts I exerted to locate my said original


Certificate of Registration, I could not find the same. I can
only assume that he may have misplaced it and the same should
now be presumed lost for all intents and purposes

5. I am executing this affidavit to attest to the veracity of the


foregoing facts, for the purpose of requesting a replacement
original Certificate of Registration with the Land
Transportation Office, and for any legal purpose this may
serve.

In witness whereof, I have herein set my hand this 3rd day of


December 2018 at Zamboanga City, Philippines.

EDGAR A. SULAIMAN
Affiant

- Oath -

Republic Of The Philippines)


City Of Zamboanga. . . . . )S.S.
X - - - - - - - - - - - - X)
SUBSCRIBED AND SWORN TO before me, this 3rd day of December,
at Zamboanga City, Philippines, affiant Edgar A. Sulaiman exhibiting
to me competent evidence of his identity through his Zamcelco ID No.
078963-06, issued by the ZAMCELCO, Zamboanga City.

Doc. No.: 123; ​Atty. MICHAEL P. MOLINA, cpa 


Page No.: 026; ​NOTARY PUBLIC 
Book No.: 036; No. 64 J.R. Estrada Street, Tetuan, ZC 
Series of 2018. Zamboanga City: 37-2018: until 12.31.2019 
IBP Roll No. 40612: IBP OR No. 23851,01.10.2018, ZC 
PTR OR 1622786,01.03.2018,ZC