Republic of the Philippines)

City of Taguig ) S.S.

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AFFIDAVIT OF LOSS

I, IRISH ANN E. LEVANTINO, of legal age, Filipino, single and a

resident of Purok Pagkakaisa, Zone 7B Western Bicutan, Taguig City, after
having been sworn in accordance with law hereby depose and state that:

1. That I am a 3rd Year student of Taguig City University, as such I was issued
a University ID;

2. On March 22, 2016 at around 8:00 in the evening, on my way going to my

classmates house, I remembered placing my ID at the back pocket of my
pants;

3. On my way home around 10;00 in the evening, I noticed that the same was
missing;

4. I tried to locate the said ID in the surrounding area but my efforts proved
futile and to no avail. Thus, I consider the said items lost and beyond
recovery;

5. I am executing this affidavit to attest the truth of the foregoing facts in

connection with the replacement of the above-mentioned identification
card and for all legal purpose4 it may serve.

IN WITNESS WHEREOF, I hereby sign this 8th day of August 2016 in the
City of Taguig.

IRISH ANN E. LEVANTINO

Affiant

SUBSCRIBED and SWORN to before me this 8th day of August 2016 in

the City Taguig. Affiant exhibited to me her Barangay ID with N0. WB-41665