REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAGAYAN ) S.S

CITY OF TUGUEGARAO )

AFFIDAVIT OF LOSS
I, MARIA LOURDES SAQUING, of legal age, married, Filipino
and a resident of Solana, Cagayan, after having been duly sworn
to in accordance with law, do hereby depose and state that:

1. I am in possession of a Professional Regulation

Commission (PRC)License Card bearing number 0391124
and with registration date of February 23, 2006;
2. Unfortunately, the said license card was lost in my
possession sometime in September 2017;
3. I tried to look for the said license card but it can no longer
be found despite diligent search. Thus, for all purposes and
intents, it is now considered lost;
4. I vouch the veracity of the foregoing facts for whatever
purpose and legal intents it may serve.

Further affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th

day of October 2017, in Tuguegarao City, Province of Cagayan.

MARIA LOURDES SAQUING

Affiant
SUBCRIBED AND SWORN TO, before me, this 4th day of October
2017, in Tuguegarao City, Province of Cagayan.

Doc. No. 208;

Page No. 42;
Book No. XIX;
Series of 2017.