REPUBLIC OF THE PHILIPPINES}

CITY OF CALAMBA }S.S.

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AFFIDAVIT OF LOSS
I, ALEX T. ILUMIN, of legal age, married, Filipino resident of and with postal
address at 298A Jasmin St., Amihan Vill 1 Tagapo, Sta. Rosa City, Laguna, after
having been duly sworn to in accordance with law do hereby depose and state:

1. That I am an employee of PFIZER INC., with business address at 19th -20th

FLR, 8 Rockwell Building., Hidalgo Dr., Rockwell Center, Makati, Metro
Manila;

2. That I was a holder of an OFFICIAL RECEIPT dated March 2023 with the
reflected amount ofS P14,644.38;

3. That I forwarded said receipt to the client via mail;

4. That this January 2024 I was informed that the client was unable to receive
said receipt;

5. That said receipt was most likely lost in transit;

6. That I reported the loss to my office under Report ID

B2997F68D03C44F6B7AD and exerted diligent efforts to recover said receipt
but the same could no longer be found;

7. That I executed this affidavit to attest to the truth of the foregoing and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affixed my signature this 16th day of

January, 2024 at Calamba City.

ALEX T. ILUMIN
Affiant

SUBSCRIBED AND SWORN TO before this 16th day of January, 2024 at Calamba
City.

WITNESS MY HAND AND NOTARIAL SEAL…

Doc. No. ATTY. RYAN JOSEPH D. IMPROGO

Page No. NOTARY PUBLIC
Book No. 27 CALAMBA CITY,LOS BANOS,BAY,CALAUAN,
Series of 2024 LAGUNA-UNTIL DECEMBER 31, 2025
ROLL NO.73981;NOT NO.16-2022-C
PTR NO.CC 8377063 -01-03-24/CALAMBA CITY
IBP NO.370131/11/23/2023/LAGUNA CHAPTER
MCLE Compliance No. VII-0003252