REPUBLIC OF THE PHILIPPINES)

QUEZON CITY, METRO MANILA) S.S.

AFFIDAVIT OF EXPLANATION
I, THOMAS CABATAC, of legal age, Filipino, and a
resident of No. 20 Marzan Street Bgy 424 Sampaloc Manila,
Metro Manila, Philippines, after having been duly sworn to in
accordance with law, depose and say:
1.

That I am the owner and proprietor of T.V. Cabantac

Apartment licensed to operate as Lessor located at the
above-mentioned address;

2.

That as a business entity, I was previously issued with

Official Receipts by the Bureau of Internal Revenue
(BIR) series 2011 bearing numbers from 051-500;

3.

That as a requirement to secure permit from the

afore-stated government agency relative to the
acquisition Authority to Print, the herein affiant is
constrained
to
produce/return
the
above-stated
Receipts;

4.

That however, the herein affiant cannot provide the

Receipts from 051-500 in view of the fact that the said
effects were mislaid when sometime the office was
struck by flood/typhoon and the effects were tried to be
salvaged and secured;

5.

That unfortunately, despite diligent and exhausted

efforts exerted, the same could no longer be recovered.
Thus, I am declaring and considering the aforesaid
Returns as lost beyond recovery; and

6.

That I have executed this affidavit to attest to the

truthfulness and veracity of all the foregoing and for all
other intents this might be of legal worth.
Affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand

and affixed my signature this _____ day of ____________, 2013, in
Quezon City, Metro Manila, Philippines.

THOMAS CABATAC
Affiant

SUBSCRIBED AND SWORN to before me on the date

and place above-written. Affiant exhibited to me his ID with No.
_______________________
issued
by
the
______________________________________________.
Doc. No.
Page No.
Book No.
Series of

______;
______;
______;
2013.