AFFIDAVIT OF LOSS Misplaced Pawn Ticket Celltech

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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAVITE ) S.S.

AFFIDAVIT OF LOSS
I, MARYGRACE C. DEMESA, of legal age, Filipino, with address at
Guyam Malaki, Indang Cavite after having been sworn to in accordance with law,
hereby depose and state, that:

1. I have pawned my Samsung J4T with Celltech Phoneshop for and


in consideration of the sum of Php 2,300.00 and as evidence
thereof said pawnshop issued to me Pawn ticket with control no.
CT 5407;

2. However, upon checking my files, I found out just recently that the
said Pawn Ticket was misplaced and cannot be found;

3. Despite diligent search and efforts to recover the said Pawn Ticket
the same can no longer be located;

4. I am executing this affidavit not for any unlawful purpose but for
any valid and legal purpose only.

IN TRUTH WHEREOF, I have hereunto affixed my signature this 13 th day of


December, 2019 at Alfonso, Cavite.

MARYGRACE C. DEMESA
Affiant

SUBSCRIBED AND SWORN to before me this 13 th day of December, 2019 at


Alfonso, Cavite. Affiant exhibiting to me her VIN: 2110-0165A-I0491MCD20000.

WITNESS MY HAND AND SEAL.

Doc. No.89;
Page No. 19;
Book No. LXXVI;
Series of 2019.

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