Republic of the Philippines ]

Province of Bohol ]
Municipality of Carmen ] S.S.

AFFIDAVIT OF LOSS
(Re: High School Diploma)

I, LEAH A. JUMAWID, Filipino, of legal age, single and a resident of Poblacion Sur,
Carmen, Bohol, Philippines, after being duly sworn in accordance with law, hereby depose and
say:

1. That I am a high school graduate of ST. ANTHONY ACADEMY CARMEN INC.

formerly Saint Anthony’s Academy at Carmen, Bohol, last school year 2007-2008;

2. That I was then given by the said school of a High School Diploma;

3. That said High School Diploma got lost last May 26, 2023;

4. That I exerted diligent efforts to find and recover the aforesaid High School Diploma,
however, my efforts proved futile as until now, its whereabouts still could not be
ascertained, hence, I considered it to be lost for all intents and purposes;

5. That the said High School Diploma was not transferred to any person for
consideration or used as collateral to secure obligations;

6. That I execute this affidavit voluntarily to attest to the truth of the foregoing
statements to support my request for the issuance of another High School Diploma in
lieu of the lost one;

7. That further, I execute this affidavit for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this 27 th day of March, 2023 at

Carmen, Bohol, Philippines.

LEAH A. JUMAWID
Affiant
PRC ID No. 0806686
Issued by the Professional Regulation Commission (PRC)

SUBSCRIBED AND SWORN TO before me this 27th day of March, 2023 at Carmen,
Bohol, Philippines.