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Republic of the Philippines)

In the City of Baguio………) S.S.


I, ABELARDO B. DEPAGO SR., of legal age, married, Filipino Citizen, with residence
and postal address at 63-E, Purok 24 San Carlos Heights, Irisan, Baguio City, Philippines, after
having been duly sworn to in accordance with law hereby depose and state that:

1. I am the President of QHP Homeowners Association and issued by the Bureau of

Internal Revenue (BIR) with a poster “ASK FOR RECEIPT” and was posted at our

2. When our aforementioned Association was dissolved, we closed our office and piled all our
documents in one carton;

3. However, the BIR poster was lost. I do not know how I lost it, either I misplaced it in
our house or in my working place and I couldn’t even find it in my files wherein I kept
important documents. Although I exerted diligent effort to find the said poster “ASK
FOR RECEIPT” but the same could no longer be found hence, considered forever lost;

4. Said BIR poster was never given nor pledged to anyone for any purpose whatsoever, nor
was it taken or confiscated by the authorities for any violation of the law;

5. I am executing this affidavit to attest to the veracity and truthfulness of my foregoing

statements and for other lawful intents and purposes it may serve.

IN WITNESS HEREOF, I have hereunto affixed my signature this 12th day of November,
2018 at Baguio City, Philippines.


OSCA No.: 856
Date of Issue: 04-04-2014

SUBSCRIBED AND SWORN to before me this 12th day of November, 2018 at Baguio
City, Philippines. Affiant personally appeared before me and the same person who executed this
instrument freely and willingly.

Notary Public
Commission No. 39-NC-18-R/Until: December 31, 2019
PTR No. 3397734/12-13-2017/Baguio City (for 2018)
IBP No. 1083758/12-13-2017/Baguio-Benguet Chapter (for 2018)
Roll No. 31289/5-15-81/Manila
MCLE COMPLIANCE No. VI-0000192/June 14, 2016
BIR TIN No. 121-017-652
No. 19, 2nd Floor Old Market Bldg.,
Magsaysay Ave., Baguio City, Philippines
Doc. No. 357;
Page No. 72;
Book No.XXXII;
Series of 2018.