AFFIDAVIT OF LOSS

Republic of the Philippines)

Province of Cavite) S.S.)
Gen. E. Aguinaldo, Cavite
x---------x

I, ESPERIDION A. BENCITO, of legal age, Filipino, married and with

present residence and postal address at Brgy. Kabulusan, Gen.E. Aguinaldo,
Cavite after being duly sworn to in accordance with law, hereby depose and
state:

That I am a holder of a FIREARM LICENSE CARD validly issued under my

name by the Philippine National Police;

That sometime last month, such Firearm License Card was lost somewhere
in Gen. E. Aguinaldo, Cavite due to unknown reasons;

That despite diligent search and efforts, I could not find it such that I
honestly believe that it is now beyond recovery;

That I am executing this affidavit in good faith and without any intention to
defraud or deceive;

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

foregoing and for other reliefs as may be just and equitable;

IN WITNESS WHEREOF, I have hereunto set my hand this 22nd day

of November 2017 at Gen. E. Aguinaldo, Cavite, Philippines.

ESPERIDION A. BENCITO
AFFIANT
ID PRESENTED:

SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and

in the Province of Cavite this 22ND day of November 2017. Affiant personally
came who is known to me as the same person who signed the foregoing
instrument before me and avowed under penalty of law to the whole truth of
the contents of said instrument.

Doc. No.______
Page No. ______
Book No. _____
Series of 2017