Republic of the Philippines )

Done in Lagawe, Ifugao…. ) S.S.

AFFIDAVIT OF LOSS

I, JANET AKANGAN MANGANDAT, of legal age, single, Filipino

citizen, and residing at Patoc, Boliwong, Lagawe, Ifugao, under oath hereby depose and
state:

1. THAT, I had been issued a College Diploma by the Ifugao State University
sometime on 2005 ;

2. THAT, sometime last week of January , I tried to find said College Diploma
where I usually kept it but the same cannot be found;

3. THAT, I diligently tried my best to find the aforementioned Diploma but to no

avail;

4. THAT, since then I have neither seen nor recovered the said College Diploma,
hence I deem it lost for all legal intents and purposes;

5. THAT, the said College Diploma was neither confiscated nor revoked by any
concerned government agency;

6. THAT, I am executing this affidavit to attest to the truth of the foregoing and
for all legal intents and purposes;

IN WITNESS WHEREOF, I hereby set my hand this 13th day of April 2018 at
Lagawe, Ifugao, Philippines.

JANET A. MANGANDAT
Affiant
LMDC No. A07301

SUBSCRIBED AND SWORN TO BEFORE ME, this 13th day of April 2018 at
Lagawe, Ifugao, affiant exhibited to me her LMDC No. as stated above below her name,
as proof of her identity.