AFFIDAVIT OF LOSS

I,ROWENA L. DE LEON, of legal age, Filipino, single/married, and resident

of
BLK 3 LOT 20-23 Barclay St, west Governor Heights I- Bgy Luciano Trece Marires City Cavite,
after being duly sworn according to law, hereby depose and state that:

1. I am the holder of National Certicate II (NCII) Under Caregiving-NCII With

certificate number 22042102007306 and Health Care Service NCII and Likewise holder of TM1
Trainers/assessors Methodology I,which was issued on October 7, 2022 and will be expired on
October 7, 2027 .at TESDA provincial Office

2. Sometime in O c t o b e r 2 2 , 2 0 2 2 @ a r o u n d 5 p m , I lost the above

NATIONAL CERTIFICATE 2 IN CAREGIVING NCII AND HEALTH CARE SERVICE NCII
together with my TM1, Certificate under the following circumstances:

I Happen to place all the said documents in a Transprent Plastic

Envelope on top of my office table and even did told my secretary NOT
to mind,or even touch all documents on my table since I still have
classes the whole day, when the tool keeper according to my secretary
made her daily cleaning schedule there after, several days more I
observed that the envelope with my certicates are not anymore on my
table, we all did look for it however we could not find the said envelop
anymore.

3. Despite diligent efforts exerted, I could no longer locate, find or recover the said
TM1 AND National Certificate II in Caregiving NCII and Healthcare Service NCII and to
the best of my knowledge, the same is truly lost.

4. In the event that the lost of the above mentioned certificates should hereafter be
found or located, I undertake to forward or surrender the same to Cavite TESDA PROVICIAL
office for appropriate disposal.

5. I am executing this Affidavit to attest to the truth of the foregoing statements and
to request the issuance of a new NATIONAL CERTIFICATE II IN CAREGIVING NCII AND
HEALTHCARE SERVICE NCII T M 1 C E R T I F I C A T E in lieu of the one which was
lost.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this at

.

___________________________
Affiant

SUBSCRIBED AND SWORN to before me this , affiant exhibited to

me his/her Competent Evidence of Identity by way of issued at on
.

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