REPUBLIC OF THE PHILIPPINES)

QUEZON CITY
) S.S.

AFFIDAVIT OF LOSS
I, Jemilyn Pearanda, of legal age, Filipino, with residence at No.152 Valencia St.,
Brgy. San Jose, Sta. Rita Pampanga, after having been duly sworn on oath in accordance
with law do hereby depose and say THAT:
1. I am the Account Receivables Assistant Supervisor of Oversees Trading with
business address at Unit 1909 Prestige Building, Ortigas Center, Pasig City;
2. That we received a Purchase Order (PO) # 252252 dated October 1, 2013 from
Iglesia ni Cristo representing their Sales Order from Oversees Trading in the
amount of P270,000.00.
3. That we relocated our files to our storage room last ____________. During the
time that we are retrieving our files, I have noticed that the original copy of PO #
252252 from Iglesia ni Cristo is missing.
4. Despite diligent effort to find the said document, recovery remains futile;
5. I am executing this affidavit to attest to the truth of the foregoing statements.
6. Affiant further say nothing.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of

_________________ in Quezon City.

_____________________________
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of ______________
_____, affiant exhibiting to me his CTC No. _____________ issued on ________ at
_____________.

Notary Public

Doc. No.____;
Page No.____;
Book No. ___;
Series of