Republic of the Philippines )

Quezon City ) S.S.

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AFFIDAVIT OF LOSS

I, NAMI MUGIWARA, of legal age, Filipino, married, and a resident of Quezon

City, after having been duly sworn to in accordance with law, do hereby depose and state:

1. That I am the School Head and one of the Chief Examiner of Going Merry
Elementary School, Quezon City;

2. That earlier on this day, April 3, 2024, I discovered that the “Batch Slip of the
Chief Examiner’s Transmittal Report Envelope” was missing in any of the school files;

3. That earnest efforts were exerted for the search and recovery of the said batch slip
but the same can no longer be found and I am now of the honest and sincere belief that
same is already lost and beyond recovery.

4. That I am executing this Affidavit to attest to the truth of the foregoing and for
whatever legal purpose(s) this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature on this

_______________, at Quezon City, Philippines.

NAMI MUGIWARA
Affiant

SUBSCRIBED AND SWORN to before me on this ____________, at Quezon City,

Philippines, the Affiant exhibiting to me her competent evidence of identity by way of
_____________________.