AFFIDAVIT OF LOSS

Republic of the Philippines }

Province of Bulacan } S.S.

I, Catherine Torres Leonillo, of legal age, Filipino, married and presently

residing at Lot 1D Blk 3, Tennessee Street, Pasig Green Park Village, Pasig
City, after having been duly sworn in accordance with law, do hereby depose
and state that:

1. That I am the lawful owner of a St Peter Life Plan No. N10006152P

with Plan Type as St. Francis and effective since June 11, 2010.

2. That I have received a Certificate of Full Payment but have recently

discovered the said document is irretrievably lost and can no
longer be found despite diligent efforts to locate the same;

3. That I extended my search to other parts of my house but still

could not locate the Certificate. I even solicited the assistance of all
the members of my household, but all our efforts proved futile.

3. I am executing this affidavit to attest to the truth of the foregoing,

and for whatever other legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 1st day of

August 2021.

Catherine Torres Leonilo

Affiant

SUBSCRIBED AND SWORN TO before me this 15th day of August 2021

in the Province of Bulacan affiant exhibiting to me her Driver’s License No.
D19-09-003870.

Doc. No. 210 ARACELI B. GLORIA

Page No. 70 Commission for Notary Public for Bulacan
Book No. I 3049 Bambang Bulacan Bulacan
Series of 2021 Roll Number 69656
IBP Number 154766 January 22, 2021
PTR 5974217 January 14, 2021
MCLE No. VI-0030286 until April 14, 2022