REPUBLIC OF THE PHILIPPINES)

IN THE CITY OF BATANGAS ) S.S.

x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x

AFFIDAVIT OF LOSS

I, DONNA CHRISTINE PLAZA CANONIZADO, guardian of

KURT RAVEN P. CANONIZADO (minor), Filipino, and with residence at
___________________________________________________, after having
been duly sworn to in accordance with law, hereby depose and state:

That said minor is a GRADE 7 student of

_________________________________at
____________________________________;

That as student of the said school, the following books were issued to
him: ARALING PANLIPUNAN (ASYA 7) and VENTURES 7;

That sometime on June, 2017 while he was inside the school

premises, he discovered that the said books were no longer on his table
where he usually keep it;

That diligent efforts were already made to find and locate said books
but the same were all in vain;

That I am executing this affidavit to attest to the truth of all the

foregoing facts and circumstances and inform proper authorities particularly
the administration of the above-stated School of the loss of the said books;

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of

May, 2018 at Batangas City, Philippines.

DONNA CHRISTINE PLAZA CANONIZADO

Affiant

SUBSCRIBED AND SWORN to before me this 7 th day of May, 2018

at Batangas City, Philippines.