REPUBLIC OF THE PHILIPPINES)

PROVINCE OF CAVITE ) S.S.

AFFIDAVIT OF LOSS
I, MARK AARON S. CASTAÑEDA, Filipino, of legal age and a resident of
Esperanza Ibaba, Alfonso Cavite, after being duly sworn in accordance with law depose
and state, that;

1. That I am in possession of Form 138 issued by Sacred Heart School of Cavite -

Alfonso, Cavite;

2. However, upon checking my files, I found out just recently that the said Form
138 was misplaced and cannot be located;

3. Despite further effort to recover the said Form 138 I could no longer recover the
same;

4. I am executing this affidavit to attest to the truth of the foregoing facts and not
for any unlawful reasons.

IN TRUTH WHEREOF, I have hereunto affixed my signature this ___ th day of

March, 2018 at Alfonso Cavite.

MARK AARON S. CASTAÑEDA

Affiant

SUBSCRIBE AND SWORN to before me this ___th day of March, 2018. Affiant
exhibiting to me his __________________________________.
WITNESS MY HAND AND SEAL.

Doc. No. ;
Page No.____;
Book No. LVI ;
Series of 2018.