Affidavit of Loss

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AFFIDAVIT

I, Dennis Ty of legal age, owner and/or duly authorized representative of Dreyle


Mobile Center Ltd. Co., residing at 2939 Bagac St., Manuguit, Tondo, Manila after
having been sworn in accordance with law, hereby declare that:

1. That the renewal of contract lease as stated below was lost.

TRADE LESSEE CONTRACT LOCATION LEASE LEASE END


NAME NO. CODE START

CLOUDFONE DREYLE MOBILE CENTER 12060048 CZK 007 20190501 20200430

2. That I am executing this affidavit to attest to the truth of the foregoing facts and to
support the Re-Execution of Lease Contracts.

FURTHER AFFIANT SAYETH NAUGHT.

____________________________ at _______________________________________
(Date) (Place of execution)

____Dennis Ty____
Affiant

Subscribed and sworn to before me this _____ day of _______ 20____ in


____________________, affiant having exhibited to me his/her Driver’s License No.
___________________ issued in _________________________ on ________
20_________.

Notary Public
REPUBLIC OF THE PHILIPPINES )
City/Municipality of ____________ )
___________________________ ) S.S.
Province of __________________ )

AFFIDAVIT OF SEPARATION FROM EMPLOYMENT

I, _________________________ of legal age _________________ Filipino and


residing at ______________________________________ after having been sworn
to in accordance with law hereby depose and state:

1. That I am a bonafide member of the Social Security System with SSS number
_______________________
1. That I was separated from my last employer, _____________
2. ____________________, with address at ________________
3. ____________________ on _______________ thereafter,
4. I was never again re-employed.
2. That I cannot secure a certification of separation
5. from my last employer because ________________________
3. That I am executing this affidavit to attest to the
6. truth of the foregoing facts and to support my
________________________________________________.
FURTHER AFFIANT SAYETH NAUGHT.
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this _____________ day of
_____ 20___ in Quezon City, Philippines, affiant having
exhibited to me his/her Residence Certificate No. ___________________
_______________ issued in _________________________ on ________
20_________.
Notary Public
Until December 31, 20 ___
PTR No. _____________
Issued at _____________
DOC NO. ____________ Issued on _____________
PAGE NO. ____________
BOOK NO. ____________
SERIES OF ____________

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