REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAVITE ) S.S.

AFFIDAVIT OF LOSS

I, DERICK SORIANO, of legal age, Filipino, and a resident of Pulo 1,

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

1. That, I am a graduate of Secondary Education at Cavite National High

School, Cavite City year 1997-1998;

2. That, I was issued a DIPLOMA by the above-mentioned school;

3. That said DIPLOMA was missing and must been lost sometimes in March
2019 when there was a renovation in our residential area. Despite diligent
efforts to locate it, the same could not be found and beyond recovery;

4. That I am executing this affidavit to attest into the fact of loss of said DIPLOMA for
legal purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day of May,
2019 at Cavite City, Philippines.

DERICK SORIANO
Affiant

SUBSCRIBED AND SWORN to before me this 17th of May, 2019 at City of

Cavite, Philippines, affiant exhibited to me her Identification Card.

NOTARY PUBLIC

Doc. No. ____

Page No. ____
Book No. ____
Series of 2019.