REPUBLIC OF THE PHILIPPINES)

C I T Y OF D A V A O )
X- - - - - - - - - - - - - - - - - - - - - - - - x

AFFIDAVIT OF LOSS

I, ______________________, Filipino, of legal age and a resident of Davao City Philippines,

after having been sworn to in accordance with law, depose and state:

1. That I am a holder of a School ID duly issued by Jose Maria College of Law with ID No.
2016300361;

2. That last September 18, 2019, I noticed that my school Id was missing from where I
usually kept it;

3. That I exerted earnest efforts to locate the said School ID but to no avail, as such the
same should now be considered lost beyond recovery;

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

IN WITNESS WHEREOF, I hereunto set my hand this 13th day of December 2020 in the
City of Davao, Philippines.

______________________ (Sgd.)
Affiant

SUBSCRIBED and SWORN TO before me this 13th day of December 2019 at Davao City,
Philippines.

Doc No. 5 ;
Page No. 2 ;
Book No. I ;
Series of 2019.