Republic of the Philippines)

City of Mandaue . . . . . . . .)

AFFIDAVIT OF LOSS
I, MARICEL RAMOS, Filipino, of legal age, a resident of
_______________________________, after having been duly sworn to in accordance with
the law, depose and state THAT:

1. I am the administrator and duly authorized representative of Child and Art

Academy Inc., a corporation duly organized and existing under the laws of the
Philippines as an educational institution;

2. In such capacity, I have personal knowledge that the said corporation was
registered with the Bureau of Internal Revenue and was issued a Certificate of
Registration under Tax Identification No. (TIN) 222-343623-000;

3. However, the aforesaid Certificate of Registration was misplaced or lost, and that
despite diligent efforts to locate the same, all were in vain. Thus, the subject
Certificate of Registration is considered lost beyond recovery.

4. I am executing this affidavit to attest to the truth of the foregoing facts and in
compliance with the BIR requirements.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 17 th day of

July 2013 at Mandaue City, Cebu.

MARICEL RAMOS
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this 17th day of 2013 at

Mandaue City, Cebu, affiant exhibiting her ________________________________.

Doc. No. ______

Page No. ______
Book No. ______
Series of 2013.