REPUBLIC OF THE PHILIPPINES)

La Trinidad, Benguet…………….. ) S.S.

AFFIDAVIT OF LOSS

I, FRED PA-AY POLKING, of legal age, married, Filipino citizen, and a resident
of Pico, La Trinidad, Benguet, Philippines, after having been sworn to in accordance
with law depose and state that:

1. I am a graduate of Bachelor of Science in Criminology, at the Cordillera Career

Development College, Buyagan, La Trinidad, Benguet, in 2006, as such, I was
issued a diploma;

2. In 2010 I submitted the said Diploma as part of the requirements in my

application to become a member of PNP-SAF. After my training with SAF, I went
back to take the original copy of the said Diploma but I was informed that they
don’t have any more my diploma.

3. Personnel of the office that took my application informed me that despite diligent
effort to locate the same, the said diploma is nowhere to be found, thus, I now
consider it lost and beyond recovery;

4. I am therefore executing this affidavit to attest to the truth of the foregoing and to
support my application for the issuance of a new one;

5. Finally, I am executing this affidavit for all legal intents and purposes this may
serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 12 th day of March,

2021 at La Trinidad, Benguet, Philippines.

FRED PA-AY POLKING

Affiant
PRC ID No. 0030797 (Criminologist)

SUBSCRIBED AND SWORN TO before me this 12th day of March, 2021 at La

Trinidad, Benguet, Philippines.

ATTY. JOECLE R. DONGLA

Doc. No.168 Notary Public
Page No. 35 My commission expires on Dec. 31, 2022
Book No. X TIN No.431-403-131; Roll No. 60543,3-23- 2012
Series of 2021 PTR No. 7290883, January 29, 2021, Benguet;
IBP No. 04245; December 02, 2020; Baguio-Benguet
S&B Bldg. FA 224, Km. 4, La Trinidad, Benguet