Affidavit of Loss

Republic of the Philippines)

Quezon City )S.S.

AFFIDAVIT OF LOSS
I, Jerry Joy E. Torion, Filipino, of legal age, and a resident of 19 Upper
Kalinisan Brgy Batasan Quezon City, Philippines, after being duly sworn in
accordance with law, depose and state:
That I am the user of a certain issued firearm, more particularly described as
follows:

Make/Kind : Revolver
Model : 38 Cal.
Serial No. : AYU 5679

That last April 7, 2024 around 2am at Abiva Publishing House Inc., the
issued firearm to me was stolen. It’s my fault and I were guilty and
responsible for the missing firearm, Because I fell asleep during my shift.
This is happened because due to my neglectful behavior. And I am willing to
pay the lost firearm.

As such, I am executing this Affidavit of Loss to attest to the truth of the

foregoing and to support the application for the issuance of a new one in
lieu of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this____________

and affixed my notarial seal at _______________, Philippines.

____________________
Jerry Joy E. Torion
Affiant

Doc. No.________
Page No.________
Book No.________
Series of 2024