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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF TARLAC )S.S.


CITY OF TARLAC )

AFFIDAVIT OF LOSS
I, LOVNEY T. ALQUERO of legal age, married, Filipino citizen, and
resident and with postal address at 4047 Homesite, San Rafael. Tarlac
City, after having been duly sworn to in accordance with law, do hereby
depose and say:

1. That I am the holder/ owner or possessor of my original


company payslip for the month of August and September 2018
issued by DepEd;

2. That I have recently discovered that the said item is


irretrievably lost and to the best of my knowledge, can no
longer be found despite diligent efforts to locate the same;

3. That the said company pay slip has not been confiscated by
any officer of the law or the issuing officer or agency due to the
violation of any law, statue, order, rule or regulations;

4. That I hereby attest to the truth and veracity of the above-stated


statements and facts.

5. That I am executing this affidavit to attest to the truth of the


foregoing statements.

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day


of November 2018 at Tarlac City, Philippines.

LOVNEY T. ALQUERO
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of November


2018 at Tarlac City, Philippines.

Doc. No._____;
Page No._____;
Book No._____;
Series of 2018.