Republic of the Philippines)

City of Santiago ) S.S.

x------------------------------- x

AFFIDAVIT OF LOSS

I, EDWARD B. VERA CRUZ, 43 years of age, married, Filipino and a

resident of Calao East, Santiago City, after having been duly sworn to in
accordance with law, do hereby depose and states:

1. That I am a holder of TESDA National Certificate III (NC III) issued by the
Technical Education and Skills Development Authority;

2. That when I was about to renew the said certificate sometime on July 2020, I
discovered that the certificate issued to me was missing;

3. That I looked for it inside my bag and even in our house, but the same was
no longer to be found;

4. That I have exerted diligent efforts to locate and recover the said certificate
but my efforts were in vain; and

5. That I am executing this affidavit willingly and voluntarily for all legal
intents and purposes to attest to the truth of the allegations contained in the
foregoing paragraphs.

IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of

September, 2020 at Santiago City, Isabela.

EDWARD B. VERA CRUZ

Affiant
TIN: 223-960-489

SUBSCRIBED and SWORN to before me this 8 th day of September, 2020 at

Santiago City, Isabela.