REPUBLIC OF THE PHILIPPINES)

QUEZON CITY
) S.S.

AFFIDAVIT OF LOSS
I, Joseph Ramos, of legal age, Filipino, with office address at Unit 1909 Prestige
Tower, Emerald Avenue, Ortigas Center, Pasig City, after having been duly sworn on oath
in accordance with law do hereby depose and say THAT:
1. I am the Liaison Officer and the Authorized Representative of JB Music and
Sports Inc. with business address at Unit 1909 Prestige Building, Emerald
Avenue, Ortigas Center, Pasig City;
2. That upon relocation from our former office at Quezon City to the new Office at
Pasig City, the BIR Form 2303 (Certificate of Registration) was loss.
3. Despite diligent effort to find the said document, recovery remains futile;
4. I am executing this affidavit to attest to the truth of the foregoing statements.
5. Affiant further say nothing.

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

_________________ in __________________.

_____________________________
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of ______________
_____, affiant exhibiting to me his CTC No. _____________ issued on ________ at
_____________.

Notary Public

Doc. No.____;
Page No.____;
Book No. ___;
Series of 2014.

REPUBLIC OF THE PHILIPPINES)

QUEZON CITY
) S.S.

AFFIDAVIT OF LOSS
I, Jesus S. Fernando, of legal age, Filipino, with postal address at Unit 1909 Prestige
Tower, Emerald Avenue, Ortigas Center, Pasig City, after having been duly sworn on oath
in accordance with law do hereby depose and say THAT:
1. I am the Owner of Salonga Music and Sports Shop with business address
at Rustans Superstore Times Square Socorro, Cubao, Quezon City;
2. That upon renovation of the store last September 2013, the Original DTI
Certification and the application form was removed to its original place
due to painting jobs at the store.
3. That the documents were put to a box for safekeeping. And later notice
that the Original DTI Certificate is intact but the Application form cannot
be found.
4. Despite diligent effort to find the said document, recovery remains futile;
5. I am executing this affidavit to attest to the truth of the foregoing
statements.
6. Affiant further say nothing.

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

_________________ in __________________.

_____________________________
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of ______________ _____,
affiant exhibiting to me his CTC No. _____________ issued on ________ at
_____________________.

Notary Public
Doc. No.____;
Page No.____;
Book No. ___;
Series of 2014.