REPUBLIC OF THE PHILIPPINES )

CITY OF LAOAG ) S.S.

AFFIDAVIT OF LOSS

I, CONNIE C. LORENZO, of legal age, Filipino Citizen and a resident

of Brgy. 47, Laoag City, Ilocos Norte, Philippines, after having been duly
sworn to in accordance with law, do hereby voluntarily depose and state:
That----

1. I have graduated at Ilocos Norte Arts and Trade (INCAT) and CABEZA
Elementary School (CABEZA) Laoag City;

2. As such, I was issued a diploma, transcript of records and other

school records;

3. Before I went abroad I was carrying fixing my papers for my visa.

Thus, I was carrying with me my diploma, transcript of records and other
school records, and I placed the said documents inside a brown envelope;

4. Due to the exigencies and things I have to do, the brown envelope that
contains my diploma, transcript and other school records was lost
unnoticed;

5. Upon discovery, I exerted efforts to locate the same. I even gone over
my files thoroughly to the point of re-arranging everything in bags but to no
avail, hence, the said original copy of the said diploma, transcript of records
and other school records are now deemed lost and beyond recovery;

6. The diploma, transcript of records and other school records have never
been confiscated in violation of any existing laws and regulations of any
country nor the same been pledged to secure any obligation; and

7. I am executing this affidavit to attest to the truth of the foregoing facts,

most specially the fact that my original copy of Diploma, transcript of records
and other school records are now deemed lost and beyond recovery. I am
also executing this affidavit for whatever legal purpose it may serve.

IN TRUTH WHEREOF, I have hereunto set my hand this April 16,

2018 at Laoag City, Philippines.

CONNIE C. LORENZO
Affiant

SUBSCRIBED AND SWORN to before me this April 16, 2018 at

Laoag City at Laoag City, Philippines, affiant exhibiting to me her Passport
ID No. EC1469657 valid until valid until 06/23/19.

Doc. No.
Page No.
Book XI
Series of 2018