AFFIDAVIT OF LOSS
I, xxxxxxxxxxxxx, Filipino,
single, of legal age and a resident of
xxxxxxxxxxxxxxxxxx, Calamba City,
Philippines, after having been duly
sworn to in accordance with law, do
hereby depose and say:
xxxxxxxxxxxxxxxx
Affiant
xxxxxxxxxxxxx
ATTY. xxxxxxxxxxxxxxxxx
Notary Public
Doc. No. ______;
Until December 31, 2019
Page No.______; PTR No.
Book No.______;
Series of 2019. xxxxxxxxxxxx0/January
xxxxxxxxxxx
ROLL NO.
xxxxxxxxxxxxx/xxxxxxxxxx
xxxx
MCLE Compliance No.
xxxxxxxxxxxxxxxxx