Republic of the Philippines )

City of Puerto Princesa ) S.S.

AFFIDAVIT OF LOSS PAWN PAPER

I, JOHN LEE BENZON, single, of legal age, Filipino, and a resident of

Vincent Heights Lanang, Davao City after being duly sworn to in accordance with
law, do hereby depose and state;

1. That I am a holder of a Pawn paper issued by Cebuana

Lhuillier, Gaisano Mall branch with ticket number 60383SG;

2. That the pawn tickets has the following details:

Loan Date: May 20, 2016
Maturity Date: June 20, 2016
Expiry Date: Sept 19, 2016
Item Description: Necklace with pendant twist Rope
cross with text mark
Grams J1
Karat 4.1
Principal: 6,765.00

3. That I have lost and misplaced the said pawn paper in the
house;

4. That I have searched such pawn paper with due diligence

but have not found it;

5. That I declare that the same is lost and can never be found;

6. I am executing this Affidavit in good faith, for whatever legal

purpose it may serve and to attest to the veracity of the
foregoing;

IN WITNESS WHEREOF, I have hereunto set my hand this July 27, 2023
Puerto Princesa City, Palawan.

JOHN LEE BENZON

Affiant
DL – J04 – 020 091207

SUBSCRIBED AND SWORN TO before me, this July 27, 2023 at Puerto
Princesa City, Palawan, affiant personally appeared to me.

Doc. No.:
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Series of 2023