REPUBLIC OF THE PHILIPPINES )
PROVINCE OF C E B U )S. S.
AFFIDAVIT OF LOSS
I, Fher Jun P. Guiritan, of legal age, Filipino, single and a resident of San
Roque, Liloan, Cebu, Philippines, after having been duly sworn to in accordance
with law, hereby depose and say, THAT:
1. I am the lawful holder/owner of a Cebuana Lhuillier Pawnshop Pawn
Receipt. It was issued in its Yati, Liloan Branch with ticket number.
This is for my a Chinese Gold Pinky Ring I pawned.
2. Last May 26, 2022 (Thursday), I attended a team building of our
school/ company, when I arrived home I realized that my wallet got lost
with my money and the pawn ticket of my jewelry. I contacted the host
and found office of the resort but sadly they found nothing.
3. I exerted diligent effort to locate the same, in the vain hope that the
abovementioned thing could be recovered, however, such undertaking
prove to be of no use, hence, the aforesaid thing is considered lost
forever.
4. Finally, I am executing this affidavit of loss in order to inform the
authorities/Cebuana Pawnshop and that I will be able to recover my
pawned items.
IN WITNESS WHEREOF, I have hereunto affixed my signature this June
4, 2022, in Naga City, Cebu, Philippines.
Fher Jun P. Guiritan
Affiant
SUBSCRIBED AND SWORN TO before me this June 4, 2022, in Naga City,
Cebu, Philippines. Affiant exhibited to me her multi-purpose with ID no. CRN-
000 6289-8995-6
Doc. No.
Page No.
Book No.
Series of 2022.
AFFIDAVIT OF LOSS Page 1 of 1 page