Republic of the Philippines)

City of Zamboanga )s.s.

X-----------------------------------X

AFFIDAVIT OF LOSS

I, EDWIN MASIKAP TANECA, of legal age, married, Filipino citizen and a

resident of Imus, Cavite City, Philippines, after having been duly sworn to in accordance
with law, hereby depose and say, that:

1. I am an active member of Philippine Coast Guard, as such I owned a

Firearm, with the following description, to wit:

Control No. Firearms Kind/Make Model/Calibre Serial

License No. Number
I-A0146507 FO7SD0060254 PISTOL/VIPER 38s 10647

2. I usually kept said Firearm inside a Cabinet of my Quarters inside the Camp
for safekeeping;

3. However, sometime of May, when I came from my duty, I noticed that the lock
of my Cabinet was destroyed and said firearm was no longer inside and lost;

4. I exerted diligent efforts in order to locate the same within the quarters and I
even search and question my subordinate, for verification on said theft
incident;

5. Hence, for all intents and purposes, I hereby declare that the above
mentioned Firearm is considered lost and beyond recovery ;

6. I execute this Affidavit to attest to the truth of the foregoing facts based on my
personal knowledge and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this ____ of July,

2014 at Zamboanga City, Philippines.

EDWIN MASIKAP TANECA

Affiant
_________________________

SUBSCRIBED AND SWORN to before me on this ______ of July, 2014 at

Zamboanga City, Philippines. Affiant exhibited to me his valid identification card, the
details are written above.

Doc. No ___
Page No. ___
Book. No. ___
Series of 2014