Affidavit of Loss

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AFFIDAVIT OF LOSS TAX CLEARANCE

REPUBLIC OF THE PHILIPPINES)


QUEZON CITY ) S.S.
x-----------x

AFFIDAVIT OF LOSS

I, John Patrick Halog, Filipino, of legal age, single,and a resident of 34 Gandhi St.,
Filinvest II, Batasan Hills, Quezon City, Philippines, after being duly sworn in accordance
with law, depose and state:

That I am the duly authorized/ representative of Advancekonek Corp., a corporation


duly organized and existing under and by virtue of the laws of the Republic of the
Philippines.

That being registered with the Bureau of Internal Revenue, Advancekonek Corp. has
been issued a Tax Clearance;

That sometime in January 2019, the original copy of the said Tax Clearance could not
be found and that despite of diligent search and efforts, the same could no longer be
found such that I now believe that it is now lost beyond recovery.

As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and
for whatever legal purposes that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of ______, 2019 at
Quezon City, Philippines.

JOHN PATRICK D. HALOG

SUBSCRIBED AND SWORN to before me this ________ day of _________. Affiant exhibited
his Philippine Passport No._EC1936663__issued on _August 20, 2014__at __DFA NCR
NORTHEAST___.

NOTARY PUBLIC

Doc. No.________
Page No.________
Book No_________
Series of_________

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