REPUBLIC OF THE PHILIPPINES

CITY OF BATANGAS

AFFIDAVIT OF LOSS

I, Dhel Mark B. Delco, a Filipino of legal age, single and a resident of 118, Pingkian 1, Pasong Tamo
Quezon City after having duly sworn to accordance with the law, I hereby depose and say that:

1. I am a holder of a Registered Electrical Engineer Identification Card issued by Professional

Regulation Commission;
2. I lost said identification card last June 10, 2021, due to pickpocket and that I exerted all my
effort to find yhe culprit and now considered lost for all legal purposes;
3. Said identification card was not confiscated by any officer of the law by reason of any violation
of any law, ordinance, presidential decree or rules and regulation of the said commission; and
neither was it offered as collateral for any loan;

I am exerting this affidavit to attest to the foregoing facts;

IN WITNESS WHEREOF, I have hereunto set my hand this ___ of _______ in the City of Batangas.

DHEL MARK B. DELCO

Affiant

SUBSCRIBED AND SWORN to before this ______________________in the City of

______________________ affiant having exhibited to me his/her community tax certificate with no.
_________________ on ___________________ at __________.

Doc. No. _________;

Page No. _________;

Book No. _________;

Series of 2021.