REPUBLIC OF THE PHILIPPINES  )

CITY     OF   SURIGAO   ) S. S.
X----------------------------------------------X
 
AFFIDAVIT OF LOSS 

I, JESSA MA. VIC T. MASCARDO, Filipino, of legal age, single and a resident
of Brgy. Taruc, Socorro, Surigao del Norte, Philippines, after having duly sworn to
in accordance with law, hereby depose and say that:

1. I am a holder of a School Identification Card (I.D.) of Surigao State

College of Technology (SSCT) issued by the latter sometime on June
2015;

2. The said school I.D. was in my possession until I found out that it was
missing this September 2015;

3. I exerted diligent search and efforts to locate the said I.D. but the same
remains futile;

4. Hence, it is now safe to declare that said school ID is lost and beyond
recovery;

5. As such, I am executing this affidavit to attest to the foregoing facts, to

establish its loss and for whatever legal purpose that this affidavit may
serve;
 
       IN WITNESS WHEREOF, I have hereunto set my hand this September 14,
2015, in the City of Surigao, Philippines.
                                
         JESSA MA. VIC T. MASCARDO
Affiant

SUBSCRIBED AND SWORN to before me this September 14, 2015, at

Surigao City, Philippines.