REPUBLIC OF THE PHILIPPINES)

MATAASNAKAHOY, BATANGAS ) S.S.

AFFIDAVIT OF LOSS

I, REYMOND T. CAPINIG, of legal age, Filipino citizen and a resident of Brgy. III -
Longos Mataasnakahoy, Batangas, Philippines, after having been sworn to in accordance with
law hereby depose and state that:

1. That I am the owner of a Student Identification Card (ID) issued by the

Philippine State College of Aeronautics (PHILSCA) – Lipa City;

2. That I am wearing the said school ID with number 12021FR-000246;

3. That on December 15, 2023, I was at the jeepney and upon heading home I realized
that my School ID got detached on the lace and/or went missing;

4. That I took diligent search and efforts to locate my Student ID, but I could not find
the same, hence, I believe it is now beyond recovery;

5. I am executing this Affidavit of Loss to attest to the truth of the foregoing statement,
and to request for a replacement of my “Student ID” and for whatever legal purpose
it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17 th day of January, 2024
at Mataasnakahoy, Batangas, Philippines.

REYMOND T. CAPINIG
Affiant

SUBSCRIBED AND SWORN to before me this 17th day of January, 2024 in

Mataasnakahoy, Batangas. Affiant exhibited to his competent evidence of identity as
__________________________.

Notary Public

Doc. No. 88;

Page No. 19;
Book No. VIII;
Series of 2024.