REPUBLIC OF THE PHILIPPINES PROVINCE OF SORSOGON CITY OF SORSOGON

AFFIDAVIT OF LOSS

I, MA. VICTORIA D. DULPINA, of legal age, Filipino, single and a resident of Baribag, Brgy. Bibincahan, Sorsogon City, after having been duly sworn in accordance with law, hereby depose and say; 1. That I am the proprietor/owner of M.V.D. Dulpina Enterprises engage in selling decorative stones; 2. That I have been issued by the Department of Trade and Industry a Certificate of Business Name Registration last December 29, 2010, valid until December 29, 2015; 3. That unfortunately, said Certificate of Business Name Registration was misplaced at our residence; 4. That in spite of my diligent efforts to locate the said Certificate of Business Name Registration it can no longer be located; 5. That I am executing this affidavit to attest to the foregoing facts and for whatever purpose this may serve. IN WITNESS WHEREOF, I have hereunto affixed my signature this 20th day of December, 2013 at Sorsogon City.

MA. VICTORIA D. DULPINA Affiant

SUBSCRIBED AND SWORN to before me this 20th day of December, 2013 at Sorsogon City, affiant being personally known to me.