REPUBLIC OF THE PHILIPPINES )

_____________ ) SS

AFFIDAVIT OF LOSS

I, XXXXX, of legal age, with business address at BBZ Bldg., Matilde Street,
corner Kalayaan Ave., Bgy. Poblacion, Makati City, after having been duly sworn in
accordance with law, hereby depose and state that:

1. I am the duly elected and qualified Corporate Secretary of

YYYYYYYYYYYY CORPORATION (the “Corporation”), a corporation duly
organized and existing under and by virtue of the Republic of the
Philippines, with principal office at BBZ Bldg., Matilde Street, corner
Kalayaan Ave., Bgy. Poblacion, Makati City;

2. As the Corporate Secretary, I hold in my custody the corporate records of

the Corporation;

3. However, due to the operations of the Corporation, we moved from one

location to another, and some of our personnel did not exercise care and
diligence in the transportation of the Corporation’s files. As a result, the
Stock and Transfer Book of the Corporation was misplaced;

4. Despite diligent search and efforts to locate the Stock and Transfer Book
of the Corporation, I am unable to locate it;

5. To the best of my knowledge, no action or proceeding has been filed or is

pending before any Court involving an intra-corporate dispute and/or
claim by any person or group against the Board of Directors, individual
directors and/or major corporate offices of the Corporation as its duly-
elected and/or appointed directors or officers or vice versa.

6. I am executing this affidavit to attest to the truth of the foregoing facts, and
to request for a replacement of the said Stock and Transfer Book of
YYYYYYYYYYYYYYYYYY CORPORATION

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____day of

____________ 2016, at Manila, Philippines.

XXXXXX

SUBSCRIBED AND SWORN TO before me, a notary public in and for

_____________________ this ____ day of September 2016. The affiant, whom I identified
through the following competent evidence of identity: _______________, valid from
________ and issued by _______________, personally signed the foregoing instrument
before me and avowed under penalty of law to the whole truth of the contents of said
instrument.
Doc. No. ........; NOTARY PUBLIC
Page No. .......;
Book No. .......;
Series of 2016.