Affidavit of Loss Raffle Ticket

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REPUBLIC OF THE PHILIPPINES )

TUBAO, LA UNION ) S.S.


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

AFFIDAVIT OF LOSS

I, NOVELYN R. SALVATIRA, of legal age, Filipino, married and a resident


of Brgy. Garcia, Tubao, La Union, after having been duly sworn to in accordance
with law, depose and state:

1. That I am a holder of a winning raffle ticket from Magic Group of Companies


having won P5,000 MAGIC GIFT CERTIFICATE hereinafter referred as Magic;

2. That I used to have the said raffle ticket in my wallet and bag;

3. That sometime on March 6, 2018, when I received the Notification Letter from
Magic, I discovered that said raffle ticket is not in my wallet and bag;

4. That diligent effort to locate the same in and around our house proved futile;

5. That I am executing this affidavit to attest to the foregoing facts and for any
legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th day of


March, 2018 in Tubao, La Union, Philippines.

NOVELYN R. SALVATIRA
Affiant

SUBCRIBED AND SWORN TO before me this 18th day of March, 2018, for
Tubao, La Union, affiant exhibiting to me her valid proof of identification.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2018.

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