REPUBLIC OF THE PHILIPPINES)

______________________ ) S.C.

AFFIDAVIT OF LOSS

I, _______________, of legal age, Filipino and a resident of

_________________________________, after having been duly sworn to in
accordance with law, hereby DEPOSE and STATE:

1. That I am a Second Year College Student taking Bachelor of

Science in Marketing Management at
__________________________________ in the academic year of
2019-2020 ;

2. By reason of the foregoing, a School Identification Card was duly

issued in my favor by the said educational institution;

3. That sometime in September 2019, when I was changing my

uniform, I found out that the said School Identification Card was
already nowhere to be found;

4. That I have exerted every possible effort at finding said School

Identification Card but everything proved futile. Thus, I now
consider the same as irretrievable and beyond recovery;

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

foregoing facts, to report such loss to the proper authorities, to
facilitate the issuance of a new School Identification Card in lieu
of the lost one, and for whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of

_______________ 2019 at _________, Manila

____________________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of _______________

2019 at _______________, Manila, affiant exhibiting to me her Competent
Evidence of Identity with No. _______________, issued at _________________.

Doc. No.____
Page No.___
Book No.___
Series of 2019.