Republic of the Philippines )

Makati City ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, Carol Joyce C. Navidad, of legal age, Filipino, single, and a resident of Blk. 2
Lot 9, Phase 2, Golden City Subd., Imus, Cavite, after having been sworn in accordance
with law, hereby deposes and states the following:

1. I am holder/owner/ or possessor of the student ID of De La Salle University –

Dasmarinas;

2. I have recently discovered the said item is irretrievably lost and can no longer be
found despite diligent efforts to locate the same;

3. I execute this affidavit to attest to the truth of the foregoing.

Signed on the date and at the place indicated below.

Carol Joyce C. Navidad

ID: Passport P2415975A
issued on: March 22, 2017
at: DFA Manila

SUBSCRIBED and SWORN TO before me on the date and at the place indicated below.
The affiant exhibited to me his competent evidence of identity as indicated above.

Signed this March 6, 2020 at Makati City, Philippines.

WITNESS MY HAND AND SEAL.

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