REPUBLIC OF THE PHILIPPINES)

Municipality of Cordova…………… ) S.S.

AFFIDAVIT OF LOSS

I, ANALIE B. ROLDAN, Filipino, of legal age, and presently residing at Poblacion,

Cordova,Cebu, after having been sworn in accordance with law hereby depose and state:

1. That I am registered highschool teacher of Cordova National High

School- Division of Cebu Province for quite sometime already until at present
and a holder of Employee ID#6096269;

2. That sometime on January of 2023, I happened to distribute some

books for students in our school while I was pregnant during that time and
gave birth few months thereafter, after I went back to school in May of 2023
I found out there were sixty two (62) lacking books in my inventory despite
my request through Presidents of each class to account every books being
endorsed to them until the school year ended pending the accounting of
those books to be returned at our end;

4. That diligent efforts were exerted by me and other co-teachers to

locate the said unaccounted books, however it remained futile or the said
remaining books can no longer be found until this time.

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

and in support of any processes at our school relative to those
unaccounted/missing books.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ______________
2023, at Cordova, Cebu, Philippines

ANALIE B. ROLDAN
Affiant

SUBSCRIBED AND SWORN to before me, this ______ day of___________, 2023 in
Cordova, Cebu, Philippines, with affiant exhibiting her ID No._________________ issued at
______________________________.

Doc. No. ________;

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