Republic of the Philippines

Province of Leyte
Municipality of Palo

AFFIDAVIT OF LOSS

I, KEAN GABRIEL C. DUMAPIAS, Filipino, single, with residence and

postal address at San Gerardo Heights, Tacloban City, after having been duly
sworn to in accordance with law, hereby depose and say, THAT:

a. I enrolled as GRADE 8 at Eastern Visayas State University

(EVSU), Tacloban City for the school year 2019 – 2020. As
such I was issued a school ID by the above-mentioned
school;

b. Unfortunately sometime in November 2019, when I

looked for the above-mentioned school ID, the same
could not be found and must have been misplaced;

c. Despite of diligent search and efforts, the same could no

longer be found such that I now believe that it is now
beyond recovery;

d. I am executing this Affidavit in order to attest the facts

and truthfulness of the foregoing statements, to
substantiate my claim that my school ID was indeed lost.

IN WITNESS WHEREOF, I hereunto set my hand this 28th day of

January 2020 at Palo, Leyte, Philippines.

KEAN GRABRIEL C. DUMAPIAS

Affiant
Personally known

SUBSCRIBED and SWORN TO BEFORE ME this 28th day of January

2020 at Palo, Leyte, Philippines.

Doc: 322 ATTY. SHARON R. VILLONES

Page: 67 Notary Public
IBP Lifetime No. 017319
Book: III Roll No. 67394/May 24, 2017
Series of 2020 PTR No. 3863160/Jan 7, 2020/Palo, Leyte
N.C. No. 2019-01-53 valid until Dec 2020