Republic of the Philippines

City of Naga

AFFIDAVIT OF LOSS

I, Jessica P. Escriba, of legal age, single, Filipino, and a resident of Zone 3, San Jose,
Bombon, Camarines Sur under oath depose and say:

1. That I am a student of University of Nueva Caceres;

2. That being a student of said university, I was issued an Identification card (I.D) with no.
15-01378;
3. That unfortunately, said school I.D through inadvertence and excusable negligence was
lost, when I misplaced it last June 7, 2019;
4. The diligent efforts to locate my I.D. went for naught, thus the same is now considered as
totally lost;
5. That I am executing this affidavit to attest to the truth of the foregoing and for whatever
legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ______day of June, 2019 at
Naga City Philippines.

JESSICA P. ESCRIBA

Affiant