Republic of the Philippines )

Marikina City ) S.S.

AFFIDAVIT OF LOSS

I, KURT SYMON A. CRUZ, of legal age, Filipino and a resident of 17-G G.H. Del
Pilar St. Cubao, Quezon City, after having been duly sworn in accordance with law, hereby
depose and state that:

1. I was a holder of my School Identification Card issued by the STI College

Marikina.
2. However, said School Identification Card was lost sometime on May 31, 2023 in
the vicinity of Quezon City.
3. Despite diligent search and efforts to look for said School ID, the same could no
longer be found.
4. Said School ID was not confiscated by the proper authorities by reason of any
violation of laws, school rules or regulations.
5. I am executing this affidavit to attest to the truth of foregoing facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 01 June 2023, in

Marikina City, Philippines.

KURT SYMON A. CRUZ

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 01 June 2023, in the City of

Marikina, Philippines, by KURT SYMON A. CRUZ, affiant exhibiting to me as competent
evidence of identity his _____________________.

WITNESS MY HAND AND NOTARIAL SEAL on the date and in the place written
above.

ATTY. LIZA JANE B. ESTAÑO

Notary Public for City of Marikina
Until December 31, 2023
Attorney’s Roll No. 57533
IBP No. 264081 / 01-03-23
PTR No. 9390201 / 01-03-23
MCLE Compliance No. VII–0020076/April 14, 2025

Doc. No. _________ ;

Page No. _________ ;
Book No. _________ ;
Series of 2023.