REPUBLIC OF THE PHILIPPINES)

ILOILO CITY )SS.

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AFFIDAVIT OF LOSS
(School I.D. – ISAT-U)

I, HANNIE RHEINE ZAMORA, of 15 years old, Filipino, single and

resident of Brgy. Baldoza, La Paz, Iloilo City, under oath depose and state,
that:

1. I am currently a Grade 10 student of University of Science

and Technology University (ISAT-U).

2. I was issued a school identification (I.D.) card when I enrolled in my

Grade 7 during school year 2016-2017 re-validated yearly ;

3. Recently, I tried to look for my school I.D. but I have misplaced it

and could no longerfind the same;

4. Despite diligent effort on my part to locate my school I.D., the same

could not be found and I now consider it lost beyond recovery for all legal
intents and purposes; and

5. I am executing this affidavit for the purpose of attesting to the loss of

my school I.D. in order to facilitate the replacement thereof and to attest to the
truth of the foregoing facts.

AFFIANT FURTHER SAYETH NAUGTH.

IN WITNESS WHEREOF I have hereunto set my hand this

January 23, 2020 in the city of Iloilo, Philippines.

HANNIE RHEINE ZAMORA

Affiant

SUBSCRIBED AND SWORN to before me this January 23, 2020

in the city of Iloilo, Philippines, affiant is personally known to me hence there
is no need to present any Competent Evidence of Identification.

Doc No.: 89 ;
Page No.: 18;
Book No.: XXVI;
Series of 2020.