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Republic of the Philippines )

City of Tacloban ) SS

AFFIDAVIT OF LOSS

I, FRED EDRALIN BIBAT DEJAÑO, of legal age, Filipino, married and


a resident of Brgy. 96, Calanipawan, Tacloban City, after having been sworn to
according to law, hereby deposes and states ---THAT:

1. I am the true and licensed owner of a one (1) unit firearm, more
particularly described as follows:

MAKE: Arms Cor


MODEL: M1911 FS 6
CALIBER: 45
SERIAL NUMBER: 1335370

2. During the onslaught of Supertyphoon Yolanda last November 08,


2013, the said firearm was lost as our house was not spared from the damage and
destruction.

3. Despite diligent search and efforts to locate the firearm, I could not
find the same such that I now believe that it is now lost beyond recovery;

4. Said firearm was not confiscated by the Police or any law


enforcement agencies for any violation of the law.

5. I am executing this affidavit to attest to the truth of the loss of said


firearm and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 December


2022 in Tacloban City.

FRED EDRALIN BIBAT DEJAÑO


Affiant
PNP ID: 20L0700355

SUBSCRIBED AND SWORN to before me this 20 December 2022 in


Tacloban City.

Doc. No. 219


Page No.093 ATTY. NILE APRIL PELLERO ROBIÑO
Notary Public for Tacloban City, Leyte
Book No. V NC No. 2022-07-30 until December 31, 2023
Roll of Attorney’s No. 65007
SERIES OF 2022 IBP Lifetime No. 017601; 06-07-17; Leyte Chapter
PTR No. 6222137; 01-03-22; Julita, Leyte
AVILA, DE VEYRA & ROBIÑO Law & Notarial Office
Cor. P. Burgos and Juan Luna Streets, Brgy. 30, Tacloban City

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