REPUBLIC OF THE PHILIPPINES )

CITY OF TAGBILARAN ) S.S.

AFFIDAVIT OF LOSS

I, JUAN DELA CRUZ, of legal age, single, Filipino, with residence at

Palma St., Poblacion II, Tagbilaran City, Bohol after having been sworn to in
accordance with law hereby depose and say that:

1. That I am a graduate of the University of San Carlos, Cebu City with a

degree in Bachelor of Science in Chemical Engineering;

2. That after my graduation, I personally secured a copy of my original

Transcript of Records issued by the Registrar’s Office of the
University of San Carlos;

3. That some time in October 26, 2020, I went to Mandaluyong City for a
job interview at San Miguel Corporation;

4. That after the interview, upon arrival in my hotel room, I found out
that said Transcript of Records was lost and despite diligent efforts to
locate it, the same could not be found and beyond recovery;

5. That I execute this affidavit to attest to the truthfulness and veracity of

the foregoing facts, and for the purpose of securing another copy of
my original Transcript of Records said school, pertaining to my
intention to apply for jobs in other companies.

IN WITNESS WHEREOF, I have hereunto signed my name this 8 th

day of January 2021, in Tagbilaran City, Philippines.

JUAN DELA CRUZ

Affiant
         
      SUBSCRIBED AND SWORN to before me this 8th day of January
2021 in Tagbilaran City Philippines. Affiant exhibited to me his Driver’s
License with License No. G24-12-345678.

Notary Public
Doc. No____;
Page No. ___;
Book No. ___;
Series of 2021.