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PLDT Affidavit of Lost Stock Cert Shim Jai Ick

This document is an affidavit of loss with undertaking for 80 shares of stock in PLDT that were discovered missing. The owner, Jai-ick Shim, attests that they have not transferred or encumbered the shares. They undertake to inform PLDT if the certificate is found and surrender any replacement immediately. Shim also agrees to indemnify PLDT and its agents from any claims or liabilities arising from canceling and replacing the stock certificate. The affidavit is signed to support issuing a new stock certificate.

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Fio Jose
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171 views2 pages

PLDT Affidavit of Lost Stock Cert Shim Jai Ick

This document is an affidavit of loss with undertaking for 80 shares of stock in PLDT that were discovered missing. The owner, Jai-ick Shim, attests that they have not transferred or encumbered the shares. They undertake to inform PLDT if the certificate is found and surrender any replacement immediately. Shim also agrees to indemnify PLDT and its agents from any claims or liabilities arising from canceling and replacing the stock certificate. The affidavit is signed to support issuing a new stock certificate.

Uploaded by

Fio Jose
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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AFFIDAVIT OF LOSS

With Undertaking

I, JAI-ICK SHIM, of legal age, Korean, of legal age and a resident of


______________________________________________ Korea, after being sworn in accordance
with law, depose and state that:

1. I am the registered owner and holder of shares of PLDT, Inc. formerly Philippine Long
Distance Telephone Company (PLDT), the details of which are as follows:

Stock Certificate Number : MFO 317094


Date Issued : JULY 25, 2016
Number of Shares : EIGHTY (80)

2. The aforementioned PLDT stock certificate was discovered to be missing and despite
diligent efforts having been exerted the same could not be located.

3. I have not endorsed, sold, mortgaged, pledged, or in any manner transferred or


encumbered the said stock certificate and/or the shares represented thereby;

4. The said stock certificate and the shares represented thereby are not the subject of any
claim, dispute, or legal action or proceeding, directly or collaterally;

5. In the event that the said stock certificate is found or information on its whereabouts
comes to my knowledge after it has been replaced, I hereby undertake to inform PLDT
accordingly and to surrender to PLDT the said stock certificate or its replacement immediately.

6. I hereby further agree and undertake to hold free and harmless and to indemnify PLDT, its
stock transfer agent (BDO), and their respective directors, officers and employee, of any and all
claims, damages, charges, expenses, and liabilities of whatever nature that may arise from or in
connection with cancellation and/or replacement of the said stock certificate.

7. I am executing this Affidavit of Loss to attest to the truth of the foregoing statements and
for the issuance of a new stock certificate in my name.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of


____________ at ________________.

________________
JAI-ICK SHIM
ACKNOWLEDGEMENT

Republic of the Philippines


______________________ S.S.

Before me, a Notary Public in and for ______________, personally appeared ____________
________________ who presented to me his/her ___________________ issued on
___________ at ______________ valid until _________________. He/She acknowledged to me
that the foregoing Affidavit of Loss with Undertaking is his/her true and voluntary act and deed.

WITNESS MY HAND AND SEAL, this _________ day of __________.

Doc No.________:
Page No.________:
Book No.________:
Series No.________:

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