REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I, GIX E. TIUJONGCO, of legal age, Filipino, and resident of #299 Real St,
Pamplona 3, Las Pinas City, after being duly sworn to in accordance with law,
hereby depose and say that:
1. I am the lawful owner of a licensed firearm which is described as

follows:
KIND/BRAND: MOSBR
CALIBER: 22
SERIAL NO.: 7701
2. On
or about year_____________ at our previous residence
__________________________________ the said firearm was lost.

at

3. I have executed previously an affidavit of lost and have it received with the
Camp Crame, but the said document affidavit of loss was also inadvertently
lost in the course of our transfer of residence.
4.

Inspite of diligent efforts to look said firearm, all such efforts proved futile
and in vain up to this time, thus, I am now declaring the loss of said
firearm.

5.

Said firearm was never given, or allowed to be used, to anyone for any
transaction or disposition, nor was said firearm the subject of any
confiscation or legal process, there being no such legal process.

6. I am executing this affidavit to attest to the truth of the foregoing facts and
for all its legal intents, effects, consequences and purposes.

GIX E. TIUJONGCO
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this September 25, 2014 at
Las Pinas, affiant with his competent identification card consisting of: LTO drivers
license no. D06-86-018183 until 11/4/2015

Doc. No. __
Page No. ____
Book No. ____
Series of 2014.

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY
)S.S.

AFFIDAVIT OF LOSS
I, CHRISTOPHER P. MOLINA, of legal age, Filipino, and resident of #123
Gloria Diaz St., BF resort Village, Las Pinas City, after being duly sworn to in
accordance with law, hereby depose and say that:
7. I am the lawful owner of a licensed firearm which is described as

follows:
KIND : PISTL
MAKE: ________
CALIBER: 45
SERIAL NO.: 797789
MODEL: 1911-A2

2. On February 20, 2014 at Block 2 Lot 25, Evergreen St., Addas Greenfield
Subd., Molino, Bacoor, Cavite, the said firearm was stolen in stated address.
3. Inspite of diligent efforts to look said firearm, all such efforts proved futile
and in vain up to this time, thus, I am now declaring the loss of said firearm.
4. Said firearm was never given, or allowed to be used, to anyone for any
transaction or disposition, nor was said firearm the subject of any confiscation or
legal process, there being no such legal process.
5. I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes.

CHRISTOPHER P. MOLINA
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this February 21, 2014 at Las
Pinas, affiant with his
competent identification card consisting of:
______________________________.

Doc. No. __
Page No. ____
Book No. ____

Series of 2014.