Affidavit of Loss

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Republic of the Philippines)

Province of ___________ ) S.s.


Municipality of _______ )

AFFIDAVIT OF LOSS

I, __________________, 31 years of age, Filipino, married and a


resident of Barangay _________________ under oath do hereby depose and
say:

1. That I was issued an Honorable Dismissal by Central Mindanao University


sometime in the year 2007;

2. That recently, I tried to look for said Honorable Dismissal as I am


intending to enroll Professional Education at Valencia Colleges, Inc.,
however, I could no longer find the same;

3. That despite diligent search and efforts to said Honorable Dismissal, I


could not find the same such that I now believe that it is now lost beyond
recovery;

4. As such, I am executing this Affidavit of Loss to attest to the truth of the


foregoing and for whatever legal purpose it may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


10th day of October 2018 at Wao, Lanao del Sur, Philippines.

_______________
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of October 2018


at ____________ Philippines, affiant having exhibited to me her Philippine
Passport with No. _____________, and who signed this affidavit in my
presence and sworn as to said document that she understood the contents thereof
and that the same is her free act and deed.

ATTY. _________________________

DOC NO. ________


PAGE NO._______
BOOK NO._______
SERIES OF 2018.

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