Republic of the Philippines)

City of Mandaue. . . . . . . . . .) S.S.

AFFIDAVIT OF LOSS
I, MARILYN VILLEGAS QUILLO, Filipino, of legal age and a resident of Tabunok,
Tabuelan, Cebu, Philippines, after being duly sworn to in accordance with law, hereby depose and
state THAT:

1. I am the mother of JADE VILLEGAS QUILLO, 16 yrs. old;

2. My aforesaid son, JADE VILLEGAS QUILLO, is currently a Grade 9 student of Juan

Pamplona National High School, Tabuelan, Cebu;

3. As such, for the school year 2015-2016, my said child was issued by the aforesaid
school the following Textbooks: Mathematics and English;

4. However, during the school year, the mentioned Mathematics and English Textbooks
were misplaced and/or got lost by my son and that despite diligent search and efforts to
locate the same, I could not find them such that I now believe that they are now lost
beyond recovery;

5. In connection thereof, I hereby declare under oath that the subject textbooks were not
sold or transferred by any means to any third person but was lost as mentioned above;
and
 
6. I am executing this affidavit on behalf of my son, Jade Villegas Quillo, who is still a
minor, in order to attest to the foregoing facts and/or for any other legal purposes that
this may serve.
 
IN WITNESS WHEREOF, I have hereunto set my hand this March 30, 2016 at Mandaue
City, Cebu, Philippines.

MARILYN VILLEGAS QUILLO

Affiant
(For and on behalf of Minor Jade V. Quillo)

SUBSCRIBED AND SWORN TO BEFORE ME, this March 30, 2016 at Mandaue City, Cebu,
affiant has personally appeared and is personally known to the undersigned.

Doc. No._____
Page No._____
Book No._____
Series of 2016.