REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SURIGAO DEL NORTE)S.S.

CITY OF SURIGAO )

AFFIDAVIT OF LOSS

I, MARIETTA LERIO NALA, of legal age, married and residing at

Capitol Road, Brgy. Washington, Surigao City, Surigao del Norte, after
having been duly sworn to according to law hereby depose and state:

That I am the owner/proprietor of MARIETTA DRESSED CHICKEN

located at Borromeo St., Brgy. Taft, Surigao City;

That Bureau of Internal Revenue (BIR), Surigao City issued me

Certificate of Registration (COR) and Notice to Issue Receipts and
Invoices (NIRI) for my above-mentioned business;

That however, due to Typhoon Odette occurred last December 16,

2021, the said COR and NIRI issued to me by BIR was lost and could not
be located;

That despite of my diligent efforts to locate the said COR and NIRI,
I could not find the same such that I have good reason to believe the
same as now lost and beyond recovery;

That I am executing this affidavit in order to attest to the truth of

the foregoing circumstances and for the purpose of reporting the loss to
the Globe business center.

IN WITNESS WHEREOF, I have hereunto set my hand this 25th day

of April, 2023 at Surigao City, Surigao del Norte.

MARIETTA LERIO NALA

Affiant

SUBSCRIBED AND SWORN to before me this 25th day of April,

2023 at Surigao City, Surigao del Norte, Philippines.