Republic of the Philippines)C I T Y O F D A V A O ) SS.x- - - - - - - - - - - - - - - - - --x

AFFIDAVIT OF LOSS

I, JEREMIE A. SUAZO, Filipino, of legal age, married and a resident of Jacinto Street, Brgy. 32-D, Davao City, Philippines, after being duly sworn to in accordance with law do hereby depose and say that:

1. I am a Business Development Officer of Davies Paints Philippines, Inc., with office address at Ground Floor Che Yong Cua & Chua Association Bldg., N. Torres St., Cor. Villamor St., Barrio Obrero, Davao City;

2. As such, I was issued by the company with a cellular phone with the following specifications:

Asset Code:1004-2013-11-987Old Asset#/Serial #:#1: 537897055807026Asset Description :OE- Cellular Phone, Nokia Asha 210,Dual SimItem Name:OE-Cellular Phone;

3. However, sometime on March 2015, such company-issued cellular phone was lost;

4. Notwithstanding diligent efforts exerted to find it, the same was not found, recovered, or located, hence, considered lost for all intents and purposes;

5. I am executing this affidavit without any fraud or intent to deceive on my part and I forever free any person from any liability that may arise from this circumstance, and/or any entity, be it governmental or private;

6. I am likewise executing this affidavit to attest to the truth of all the foregoing and to apprise the company, Davies Paints Philippines, Inc., of such fact of loss and for all other legal purposes this affidavit may serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2nd day of June 2015, at Davao City, Philippines.

JEREMIE A. SUAZOAffiantSSS I.D. No. 09-2212433-6

SUBSCRIBED and SWORN to before me, in the City of Davao, this 2nd day of June 2015, affiant exhibiting to me his competent evidence of identity first written above below his name.

Doc. No. ______Page No. _____Book No. _____Series of 2015.