Republic of the Philippines)

Malolos City, Bulacan ) S.S

AFFIDAVIT OF LOSS
I, REYNALDO S. BANATO, of legal age, single, Filipino, and a
resident of Richville Subdivision, Tagumpay Street, Brgy. Sindalan, City of
San Fernando, Pampanga, after having been duly sworn to in accordance
with law do hereby depose and state, that:

1. I am a holder of a Transcript of Records of my College Diploma

issued by Our Lady of Fatima University College;

2. Sometime in November 2017, we moved in from Batangas to

Pampanga; when I look and check my documents, I found out
that the said Transcript of Records of my College Diploma was
missing;

3. The said Transcript of Records of my College Diploma must been

misplaced after we moved in from Batangas to Pampanga;

4. I have exerted diligent efforts to locate the same but all my efforts
proved to be all in vain; and

5. I am executing this Affidavit of Loss to attest the truth of the all

foregoing statements and to inform the authorities for all legal
intents and purposes it may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 13 th

day of January 2020, at Malolos City, Philippines.

REYNALDO S. BANATO
Affiant

SUBSCRIBED AND SWORN to before me this 13th day of

January 2020. Affiant exhibited to me his ______________________.

Doc. No. 296;

Page No. 61;
Book No. XIV;
Series of 2020.