(Affidavit of Loss - School ID)

REPUBLIC OF THE PHILIPPINES) Province of ____________________) S.S. City/Municipality of _____________) x-----------------------x

AFFIDAVIT OF LOSS

I, _____________, Filipino, of legal age, (single / married), and a resident of _____________, after being duly sworn in accordance with law, depose and state:

That as a bona-fide student of _____________, I was issued a Student Identification Card (ID) No. _____________;

That to my surprise, I discovered last _____________ that the said Identification Card could not be found;

As all efforts to find the same proved unrewarding, it is now safe to conclude that recovery of the same is an impossibility;

Thus, I execute this affidavit to establish its loss and to support my application for the issuance of a new Identification Card.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at _____________, Philippines.

AFFIANT

(JURAT)