REPUBLIC OF THE PHILIPPINES)

Malolos City, Bulacan) S.S.

AFFIDAVIT OF LOSS

I, MEDINA A. SOCOSI, of legal age, married, Filipino, and

presently residing at 41 T. Concepcion Street, Marulas, Valenzuela City,
after having been duly sworn to accordance with law do hereby deposes and
states, that:

1. I am a holder of a Promissory Note duly issued to me by UNISTAR

CREDIT & FIN CORPORATION;

2. On July 13, 2020, I bought the motorcycle to JEMINA C.

TOMELDEN as evidence by the Deed of Sale of Motor Vehicle
notarized by Atty. Ricardo M. Perez with Doc. No. 208; Page No. 43;
Book No. XV; Series of 2020; all necessary documents for
transferring of ownership into my name were given to me by the
VENDOR;

3. On February 15, 2021, when I decided to transfer the ownership of

motorcycle into my name, I discovered that the said Promissory Note
was missing, maybe it was misplaced in our house and could no
longer to be found;

4. I have exerted diligent effort to locate the same but all my efforts are
all in vain; and

5. I am executing this Affidavit of Loss to attest the truth of the

foregoing facts and to inform the authorities for all legal intents and
purposes it may serve.

Malolos City, Bulacan, February 17, 2021.

MEDINA A. SOCOSI
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 17th day of

February 2021, at Malolos City, Bulacan.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc No. 471;
Page No. 96;
Book No. XVI;
Series of 2021.