Republic of the Philippines)

Davao City ) s. s.
x- - - - -- - - - - - - -x

AFFIDAVIT OF LOSS

I, JAYSON O. IRAN, Filipino, of legal age, single, a resident of Purok XI

Panacan, Relocation, Davao City, depose and state:

1. I am a holder of a School ID issued by University of Southeastern

Philippines.

2. Sometime in November 2021, I noticed that my School ID is missing. I

looked and searched for said ID inside my house, my car, my workplace and all
the places where I frequently go to. Despite diligent efforts, I could not find it.

3. I conclude that my School ID is lost and is beyond recovery.

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

and for whatever legal purpose it may serve.

Signed on 16 August 2022 at Davao City, Philippines.

JAYSON O. IRAN
Affiant

SUBSCRIBED AND SWORN TO before me on 16 August 2022 at Davao

City, Philippines. Affiant exhibited to me his Professional Identification Card with
ID No. 0149163.

EMILIO O. SORIANO
NOTARY PUBLIC
Doc. No. 70; Until Dec. 31, 2023
Page No. 15; Serial No. 2022-176-2023
Book No. 01; PTR No. 6975444
Series of 2022. 5-25-22/Davao City
Roll of Attorney’s No. 77723
IBP O.R. No. 210408/5-13-22