Republic of the Philippines )

City of Cagayan de Oro ) S.S.

x - - - - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF LOSS

I, MONICA CARLA Q. CAALIM, Filipino, of legal age, single and a resident of #16
Capricorn Street, Villa Ernesto Phase I, Gusa, Cagayan de Oro City, Philippines, after being
duly sworn to in accordance with law, hereby depose and state:

1. That I am an employee of FDC Misamis Power Corp. in PHIVIDEC Industrial Estate,

Villanueva, Misamis Oriental;

2. That on November 11, 2017 at around 2:00 oclock in the afternoon, I lost my wallet
which I usually place in my bag;

3. That it contained an Eastwest Payroll Account, a PRC ID and receipts addressed to

FDC Power Corp., bearing an amount of 12, 950 for 6 meals, tip and gasoline expenses;

4. That despite diligent search and efforts to locate the said wallet and its contents, I could
not find them such that I now believe that they are already lost beyond recovery;

As such, I am executing this Affidavit of Loss to attest to the foregoing and for whatever legal
purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this____________________ in

Cagayan de Oro City, Philippines.

________________________
MONICA CARLA Q. CAALIM

SUBSCRIBED AND SWORN TO before me this ________________at Cagayan de Oro City,

Philippines.

Doc. No. ____;

Page No.____;
Book No.____;
Series of 2017.