Republic of the Philippines

)
CITY OF CAGAYAN DE ORO) S.S.

AFFIDAVIT OF LOSS
I, ROY V. NAVA, JR, of legal age, single, Filipino and a
resident of 31st street Nazareth, Cagayan de Oro City, after having
been sworn to an oath in accordance with law do hereby depose and
say:
1. That I am a Store Specialist of Bounty Agro Ventures Inc.,
which office address is located
at CM Recto Avenue,
Cagayan de Oro City
2. That being a Store Specialist of the aforesaid company, I am
the official custodian of the following company documents
and identification cards, to wit:
a) Receipts of the payments made for the different outlets
water and electric bills;
b) Official Receipt and Certificate of Registration of the
company issued vehicle;
c) Company Identification Card;
d) Company cheques;
e) ATM Card issued by the company;
f) Voters ID issued to me by COMELEC;
g) Drivers license issued to me by LTO;
3. That on June 5, 2015, at 7:30 in the evening, more or less, I
went to one of the companys outlets located near Gaisano
Mall at Corrales Avenue, Cagayan de Oro city, in order to
deliver said outlet of supplies and consumables to be used
for its operation;
4. That when I arrived at the location, I then carefully parked
the above-mentioned company issued car at the side of the
road but fronting the outlet so that it would be easier for me
to unload said consumables;
5. That after having delivered the consumables to the said
outlet which took me approximately 40 minutes - I

immediately went back to the car as I was intending to visit

another outlet located at Macasandig before proceeding
home;
6. That when I reached our house at around 10 oclock in the
evening, I noticed that the above-mentioned documents and
identification cards were no longer inside the car;
7. That I exerted earnest effort to find and locate the same but the same was rendered fruitless;
8. That I consider the aforesaid identification cards and
company documents lost and beyond recovery;
9. That I executed this Affidavit to attest as to the truth of the
foregoing facts and for whatever legal purpose/s this may
serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this 6th
day of June, 2015 in the City of Cagayan de Oro,
Philippines.

ROY V. NAVA, JR
Affiant
SUBSCRIBED AND SWORN TO before me this 6th
June, 2015, in the City of Cagayan de Oro, Philippines.

Doc. No. 370

Page No. 74
Book No. 116
Series of 2015

day of