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REPUBLIC OF THE PHILIPPINES )

CITY OF __________ )) S.S.

AFFIDAVIT OF LOSS

I, Ma. Lorda R. Talavera, Filipino, of legal age, single and with residence at 8 Delos Reyes St.
Project 4, Quezon City, after having been duly sworn in accordance with law, hereby depose and
state THAT:

1. I am the sole owner of MALORATA INTERNATIONAL MANPOWER AGENCY, a


corporation duly organized and existing under and by virtue of the laws of the Republic of the
Philippines with office branch in Tuguegarao;

2. That being registered with Business Permit in year 2017, the Malorata Agency Tuguegarao
Branch Office has been issued a Business Plate;

3. That sometime last year , the original copy of the said Business Plate could not be found and that
despite diligent search and efforts, the same could no longer be found, such that I believe it is
now lost beyond recovery;

4. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and for
whatever legal purposes that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ________, 2018
at _____________, Philippines.

Ma. Lorda R. Talavera


AFFIANT

REPUBLIC OF THE PHILIPPINES)


CITY OF __________ ) ) S.S

SUBSCRIBED AND SWORN TO before me this ____ day of ___, 2018 at _____, affiant exhibiting
to me her Community Tax Certificate No. 22011167 issued at Quezon City.

Notary Public

Doc. No. _______


Page No. _______
Book No. _______
Series of ________
REPUBLIC OF THE PHILIPPINES )
CITY OF __________ )) S.S.

AFFIDAVIT OF LOSS

I, Marilou O. Penaso, residing at Dampil, Lagonglong Misamis Oriental, being of


legal age, depose and say that;

1. That I can no longer locate the original copy of my National certificate 11 in


Domestic Work;

2. That I made efforts to locate the document but all efforts to retrieve the said
document have proved abortive;

3. That I am in need of a certified true and correct copy of the document at this
time.

4. As such, I am executing this Affidavit of Loss to attest to the truth of the


foregoing and for whatever legal purposes that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 27th day of


February 2019 at _____________, Philippines

Marilou O. Penaso
AFFIANT

REPUBLIC OF THE PHILIPPINES)


CITY OF __________ ) ) S.S

SUBSCRIBED AND SWORN TO before me this 27th day of February, 2019


at ____________, affiant exhibiting to me her Passport # P0853664A issued on
Nov 14, 2016 at DFA Cagayan De Oro.

Notary Public

Doc. No. _______


Page No. _______
Book No. _______
Series of 2019

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