AFFIDAVIT OF LOSS CR WITH UNDERTAKING(REY B. BALMES)

Notice is hereby given that REY B. BALMES was the owner of one (1) unit motor vehicle YAMAHA MC
with Plate No. 4866PY; Chassis No. PA01KC000C0010025 and Motor No. 1KC-008565. That the owner’s
copy of Certificate of Registration of the said described vehicle was loss and despite of extra-diligent efforts exerted by the owner to locate the said CR, it could no longer be found and considered as lost. Entered under notarial registry of Atty. Benjamin B. Distura, on August 3, 2021, a notary public for and in the City of Roxas on Province Capiz as per Doc. No. 121; Page No. 26; Book No. CXXVII; Series of 2021.

The Capiz Times Publishing,
July 4, 11 & 18, 2022