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REPUBLIC OF THE PHILIPPINES) QUEZON CITY) S.S. AFFIDAVIT OF LOSS I, NILO A. MAMACLAY, Filipino, of legal age, residing at No.

19 Hillside Drive, Blue Ridge, Quezon City, after having been sworn in accordance with law hereby depose and state that: 1. I am a permanent employee of the Philippine Information Agency (PIA) holding the position of Information Officer V assigned at the Regional Operations Division (ROD); I am designated as the ROD Staff Director and concurrently the PIA Region IV-B (MIMAROPA) Officer-in-Charge; I attest to the procurement of PIA-IV-B of a certain motor vehicle which is more particularly described as follows: : : : : TOYOTA TAMARAW WAGON 1996 ENGINE NO. CHASSIS NO. PLATE NO. FILE NO. : 2C-3124312 : CF50-0023495 : SEG 153 : 1312-00000032346

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MAKE SERIES BODY TYPE YEAR MODEL 4.

The aforementioned motor vehicle was consigned with the PIA-San Jose, Occidental Mindoro Information Center sometime in April 2008 to support its operations. Sometime in 2009, the PIA-San Jose, Occidental Mindoro Information Center went out of operation as part of the governments implementation of the rationalization plan. With the closing of the aforementioned office, files were not properly secured thus leaving other files missing, including the original copy of the abovementioned motor vehicles Certificate of Registration. The PIA regional office exerted diligent efforts to locate said Certificate of Registration, but to no avail and I considered the same as lost and can no longer be found. I am executing this affidavit to attest to the truth of the foregoing and to request from the Land Transportation Office of Quezon City, a copy of said Certificate of Registration.

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FURTHER AFFIANT SAYETH NAUGHT: IN WITNESS WHEREOF, I have hereunto _______________2011, at Quezon City, Philippines. affixed my signature this___ day of

NILO A. MAMACLAY (Affiant) SUBSCRIBED AND SWORN to before me this ___ day of ____________ 2011 at Quezon City, Philippines. Affiant exhibited to me his Community Tax Certificate No. 20087172 , issued at Quezon City on January 28, 2011. NOTARY PUBLIC

Doc. No. : ________; Page No. : ________; Book No. : ________; Series of 2011.

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