REPUBLIC OF THE PHILIPPINES)

) S.S.

AFFIDAVIT

I, [NAME], of legal age, Filipino, and a resident of [Address], being duly sworn in
accordance with law, hereby depose and state that:

1. I am the duly appointed Corporate Secretary of [NAME OF

CORPORATION], hereinafter referred to as the “Corporation”, a corporation duly
organized and registered in accordance with the laws of the Republic of the Philippines
with principal office at [Principal Address of Corporation]; and,

2. Sometime in [Date], we noticed that the Stock and Transfer Book of the
Corporation, issued by the Securities and Exchanges Commission was missing. As
such, we conducted a thorough search for the same. However, our efforts proved futile.

3. Despite diligent efforts to locate the same, it can no longer be found.

4. This affidavit is being executed to attest to the veracity and truthfulness

of the above facts for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this [Date] at

[Place].

[NAME]
Affiant

SUBSCRIBED AND SWORN to before me this ______________ at

______________, affiant exhibiting to me his identification card [ID Info] issued by
[Issuing Authority] and valid until [Expiry Date].

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 20__.