REPUBLIC OF THE PHILIPPINES

(CITY OF QUEZON CITY) S.S.

AFFIDAVIT OF DESTRUCTION OR MUTILATION

I, JOYCE CAMILLE T. AGUIRAN, of legal age, Filipino, single, and presently residing at Bldg. 12
Unit 1256 MRB Brgy. Commonwealth Quezon City, after having been duly sworn to in
accordance with law, do hereby depose and state that:

1. I am the owner of the following document (the "Document"):

Certificate of Employment
Certificate of Performance Rating
Certificate of Good Moral
2. The Document was destroyed or mutilated in the following manner:
The house that I stayed in was destroyed by typhoon Ulysses last November 12, 2020
3. I am executing this affidavit to attest to the trust of the foregoing and for all legal purposes it
may serve.

IN WITNESS WHEREOF, I have hereunto signed this Affidavit this __________ day of
______________ 2020 at CITY OF QUEZON CITY, METRO MANILA.

__________________________________________
Signature over printed name

_________________________
Date

SUBSCRIBED AND SWORN TO BEFORE ME this _______________ day of ______________ 2020

at CITY OF QUEZON CITY, METRO MANILA affiant, JOYCE CAMILLE T. AGUIRAN, personally
appeared before and exhibited to me their SSS ID no. 0111-8643523-9 issued on 10 January
2020.

Doc No. _________________________

Page No. NOTARY PUBLIC
Book No.
Series No. Until____________________
PTR No._________________
IBP No.___________________