Republic of the Philippines )

City of Mandaue ) S.S.

AFFIDAVIT OF LOSS

I, HAZEL SUELLO VILAS, of legal age, Filipino, and with residence at Camino
Vicinal Street, Umapad, Mandaue City, Cebu, after having been duly sworn to in
accordance with the law, hereby depose and state that:

1. Sometime on December 2022, I pawned my 1YG ring, 1.4 grams (the “Pawned
Item”) with RD Pawnshop and for which I was issued Pawn Receipt No.
23187136 (the “Pawn Ticket”).

2. I kept the said Pawn Ticket for safekeeping but upon recent search, I discovered
that the Pawn Ticket was lost.

3. Despite diligent search and efforts to locate said Pawn Ticket, the same could no
longer be found and proved to be beyond recovery.

4. I am executing this affidavit in good faith to attest to the veracity of the foregoing
facts and have read and understood all the contents therein, and that the same
are true and correct to the best of my knowledge.

5. Further, I am executing this Affidavit to enable me to secure a duplicate or

substitute copy of the Pawn Ticket and/or redeem the above-described item
which I pawned.

IN WITNESS WHEREOF, I have hereunto signed this Affidavit this 7 th day of

February 2023 in the City of Mandaue, Cebu, Philippines.

HAZEL S. VILLAS
Affiant

SUBSCRIBED AND SWORN to before me this 7th day of February 2023 in the
City of Mandaue, Cebu, Philippines, Affiant personally appeared before me and
exhibited to me her School ID No. 1201904 as her competent evidence of identity.

Doc. No. 31;

Page No. 8;
Book No. 1;
Series of 2023.