Republic of the Philippines )
Caba, La Union ) S.S.
AFFIDAVIT OF LOSS OF BIR
Certificate Authorizing Registration (CAR)
I, MARY ANN B. CARREON, of legal age, Filipino, single and with residence and postal
address at Bautista, Caba, La Union, after having been duly sworn to in accordance with law depose
and say:
1. That the Office of the Bureau of Internal Revenue (BIR)-La Union issued the Certificate
Authorizing Registration for the property bought by Pepsi Picar Pulanco from Guadalupe
Jenin Delos Reyes, et.al sometime on March 2020;
2. That the Vendee, Pepsi Picar Pulanco handed it to me the said Certificate Authorizing
Registration on March 10, 2020;
3. That I keep the said BIR Certificate Authorizing Registration in my filing cabinet inside
our office together with other documents needed for the transfer of the said property in
the name of the Vendee;
4. That when I asked by the Vendee to return and produce all the documents for transfer
including the said BIR Certificate Authorizing Registration, the same was not in the
aforementioned filing cabinet, where I use to keep it;
5. That unfortunately, the original copy of BIR Certificate Authorizing Registration issued
by the BIR RDO 003 was lost and I took pains to look for the original copy of the said
Certificate Authorizing Registration but to no avail;
6. That I am executing this affidavit to support my request with the Bureau of Internal
Revenue (BIR) RDO 003 for the issuance of a new BIR Certificate Authorizing
Registration and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hands this 13 th day of November, 2020
in Caba, La Union.
MARY ANN B. CARREON
Affiant
Passport No. P1718328B
DFA-La Union