REPUBLIC OF THE PHILIPPINES)

SANTIAGO CITY )S.S.

AFFIDAVIT OF LOSS

I, CHERRY T. CO, of legal age, Filipino citizen, and with residence address
at Centro West, Santiago City, after having been duly sworn in accordance
with law, state that:

1. I am the registered owner of Global PH Advertising with

registered business address at ATC Bldg., Centro West, Santiago
City;

2. The said business was duly registered with the Bureau of Internal
Revenue on July 21, 2018 ;

3. Subsequently, the said business have printed 50 booklets of

receipts numbered 0001-2500;

4. Said receipts were missing;

5. Despite diligent search and efforts exerted, the said Passbook

could no longer be located, found or recovered, and to the best of
my knowledge, the same is lost; and

6. I am executing this Affidavit to attest to the correctness and

truthfulness of the foregoing, and for the closure of my business
with the BIR.

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

___________ in Santiago City.

CHERRY T. CO
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of November

______ in Santiago City.

Doc. No. ____;

Page No. ___;
Book No. ___;
Series of _____.