AFFIDAVIT OF LOSS

I, AL-KWARIZHME S. ABDUSALAM, of legal age, single, Filipino

citizen, with residence and postal address at Estrada Street,
Tetuan, Zamboanga City, Philippines, after having been duly sworn
to an oath in accordance with law, do hereby depose and say:
1. That I am a second year Bachelor Of Science in Commerce, Major
in Accounting Technology, student of the Universidad De
Zamboanga;
2. That as such, I was issued an Universidad De Zamboanga Student
Identification Card No. 2001154;
3. That I placed the said ID inside my wallet for safekeeping;
4. That sometime on April 19, 2008, when I needed the said I.D.
to enter the University campus, I discovered that my wallet
where I usually keep it could not be found;
5. That I can only assume that it was a pickpocket who stole my
wallet while I was distracted;
6. That despite diligent efforts I have exerted to locate the
said I.D. it is nowhere to be found and should now be
considered lost for all intents and purposes;
7. That I am executing this affidavit to attest to the truth of
the above facts and for the purpose of requesting a
replacement Universidad de Zamboanga Identification Card with
the Office of Student Affairs.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hand this 7th day
of July, 2008 at Zamboanga City, Philippines.

. . . . . . . . . . . . . .
AL-KWARIZHME S. ABDUSALAM
Affiant
Affiant

- Oath -
Republic of the Philippines)
City of Zamboanga. . . . . )S.S.
X - - - - - - - - - - - - X)
SUBSCRIBED AND SWORN TO before me this 7th day of July,
2008, affiant Al-Kwarizhme S. Abdusalam exhibited to me his
Community Tax Certificate No. 02941370, issued on July 3, 2008,
at Zamboanga City.

Doc. No.: 509; A tty. M IC HA EL P. MO LIN A , cpa

Page No.: 101; notary public
Book No.: 029; commissioned until 12.31.2010
No. 64 Estrada Street, Tetuan, ZC
Series of 2008. IBP OR. No.703803, 01.03.08, ZC
PTR OR. No.1930272, 01.03.08, ZC
Roll No. 40612