Republic of the Philippines )City of Tarlac )

AFFIDAVIT OF LOSS
I,
MALYYANN
, of legal age,
it’s complicated
, and a resident of Dito St.,Brgy. Lang Sa, Tarlac after being duly sworn according to law, do hereby deposeand state that:1.

I am the owner of MASSARAP BAKERY, with business address locatedat Samin Lang Din, Tarlac;2.

Being registered with the Department of Trade and Industry (DTI) last May2011, the said Government agency issued DTI Certification;3.

On August 2011, the original copy of the said DTI Certificate ofRegistration could not be found, which is believe has been lost due ontyphoon
flood;4.

Despite diligent search and best efforts, I failed to locate and recover thesaid DTI Certification to this day;5.

Wherefore, I am executing this Affidavit of Loss to attest to the truth of theforegoing and for whatever legal purposes that this may serve;
WITNESS WHEREOF
, I have hereunto affixed my signature this 18
th
dayof October 2016 at Tarlac City, Philippines. _____________________________
MALYYANN
SSS

N
O
:

3
X
-2
X
2
X
3474-0
SUBSCRIBED AND SWORN TO
before me, a notary public in and for TarlacCity this 18
th
day of October. The affiant, whom I identified through the followingcompetent evidence of identity: SSS

N
O
:

33-2058474-0, issued by Social SecuritySystem(SSS), personally signed the foregoing instrument before me and vowedunder penalty of law
to the whole truth of the contents of said instrument.Doc. No. __________Page No. __________Book No. __________Series of 2016