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Republic of the Philippines)
Makati City, Metro Manila ) S.S.
AFFIDAVIT OF LOSS
I, WILHELMINA A. POBRE, of legal
age, married, Filipino citizen, with residence address at 51-G
Yakal Street, Makati City, under oath, depose and state:
(1) I, together with my husband,
own a Certificate Of Participation No. 0044335 issued by Security
Bank in the principal amount of P100,000.00.
(2) On January 10, 1999 I lost
the original of the above Certificate of Participation when we
moved to our new house in Makati City, during which we relocated
a number of personal possessions.
(3) Diligent search of said document
among our personal effects proved futile and unavailing.
(4) I am executing this affidavit
to comply with the requirements of Security Bank for the reconstitution
of said document.
Affiant further sayeth naught.
WILHELMINA A. POBRE
SUBSCRIBED AND SWORN to before
me this day of August 1999 in Makati City, Metro Manila, affiant
exhibiting to her Community Tax Certificate No. __________ issued
on _____________ at ____________.
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 1999.
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