REPUBLIC OF THE PHILIPPINES

(CABANATUAN CITY) S.S.

AFFIDAVIT OF LOSS

I, CYVILLE ROSE ATAYDE, 25 years old, Filipino citizen and a resident of

Mambangnan, San Leonardo, Nueva Ecija, after having been sworn to in
accordance with law, do hereby depose and state that:

1. I was issued by Technical Education Skills Development Authority (TESDA) a

TESDA Competency Assessment Result Summary Slip after completing the
required program sometime in 2020 at the Top Link Global College Inc.;

2. I kept the said TESDA Competency Assessment Result Summary Slip,

together with my other personal documents, in one of the drawers inside my
room;

3. Lately, while I was organizing my personal effects, I discovered that the

above-said certificate was missing;

4. I immediately searched the said certificate in the other drawers in our house
but I found nothing. I also asked the member of our household if they found
the same but all answered in the negative;

5. All my diligent efforts exerted to locate the said TESDA Competency

Assessment Result Summary Slip proved futile; hence, I now consider the
same as lost and beyond recovery;

6. I am executing this affidavit to attest to the truth of the foregoing statement

and for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of _____

at Cabanatuan City.

CYVILLE ROSE A. ATAYDE

Affiant

SUBSCRIBED AND SWORN TO before me in _______________________

this _______________affiant exhibiting to me his/her Driver’s License
with ID Number C05-22-303097

Doc. No. _______ ;

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