AFFIDAVIT OF LOSS

REPUBLIC OF THE PHILIPPINES)

CITY OF MANILA
) S.S.
I, BIMBO D. BACIERRA, of legal age, Filipino and with
postal address at 649 Zone 68 Blk 9 Ext Baseco Port Area,
Tondo, Manila , after having been sworn in accordance with
law hereby depose and state:
That I am an employee (driver) of RAGS ENTERPRISES
located at 5251 Spazio Bernardo Condo., Champaca,
Mindanao Avenue, Quezon City;
In such capacity as driver I was entrusted with the
original copy of Official Receipt (OR) No.: PD# 152893 for
Abdulraouf located at 8040 Norzagaray Street, Quiapo,
Manila;
That on October 13, 2014,
I inadvertently
misplaced/lost the aforesaid Official Receipt (OR) No.: PD#
152893;
That I took pains to look for said (OR) No.: PD#
152893 but despite my deligent effort, I could no longer
locate or find the same;
That I am executing this affidavit to attest to the truth
of the foregoing and for whatever legal purpose it may
serve..
IN WITNESS WHEREOF, I have hereunto set my hand
this 14th day of October 2016 in the City of Manila.

D.

BIMB
BACIERRA
Affiant

SUBSCRIBED AND SWORN to before me, this 14th

day of October, 2016, in the City of Manila, with affiant
exhibiting his Driver's License No. NO4-14-024149 and
expires on November 28, 2016.
Doc. No.:_________;
Page No.:_________;
Book No.:_________;
Series of 2016