Republic Of the Philippines)

Province of Cebu ) S.S.

City of Bogo)

AFFIDAVIT OF LOSS

I, KENNETH P.TARIMAN, of legal age, Filipino, married, and resident of Tupas St.,
Bogo City, Cebu, Philippines, after being duly sworn according to law, hereby depose
and state that:

1. I am the father of GLEMARK M. TARIMAN;

2. That on January 12, 2016, upon arriving from school my son Glemark M.
Tariman take off his school ID and put it somewhere that he could not
remember where to find the next day.

3. Despite diligent efforts exerted, he could no longer locate, find or recover the
said school id, the same is truly lost.

4. I am executing this Affidavit to attest to the truth of the foregoing statements

and to request the issuance of a new school id in lieu of the one which was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________________ at

Bogo City, Cebu

KENNETH P. TARIMAN

Parent

SUBSCRIBED AND SWORN to before me this ____________________, affiant exhibited to me

his/her Competent Evidence of Identity .

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2015