REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CEBU ) S.S.

MUNICIPALITY OF MINGLANILLA )

AFFIDAVIT OF LOSS

I, ALLAN S. ACAS , Filipino, of legal age, single, and residing at Pakigne,

Minglanilla, Cebu, after being duly sworn to in accordance with law, hereby
depose and say:

That I am a holder of a CITIGYM Identification Card c/o Water Front Cebu

City Hotel & Casino, Salinas Drive Cebu City ;

That three weeks ago while I was in Manila I noticed that my CITIGYM ID
which was placed inside my pocket was gone;

That said CITIGYM Identification Card could not anymore be found

notwithstanding my diligent efforts to locate the same, hence considered as lost for
al legal intents and purposes;

That this affidavit is executed to attest to the foregoing facts and for
whatever legal purpose that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 11th day of June
2009, in the Municipality of Minglanilla, Province of Cebu, Philippines.

ALLAN S. ACAS
Affiant
Passport # XX1060268
Issued on April 30, 2008
At DFA, Cebu

SUBSCRIBED AND SWORN TO BEFORE ME, in the Municipality of Minglanilla,

Province of Cebu, this 11th day of June 2009 . Affiant showing me his Passport No., date and
place of issued as above indicated below his name and signature.

Doc No.___________;
Page No.__________;
Book No.__________;
Series of 2009.