REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SAMAR………..….) SS
CITY OF CATBALOGAN………..…)

AFFIDAVIT OF LOSS

I, IVAN KIM D. SACAGUING, of legal age, single, Filipino, and a resident of Brgy.
Poblacion 1-A, Motiong, Samar, after having been duly sworn to in accordance with the law do
hereby depose and state: THAT-

1. In March 2017, I graduated my college at the St. Mary’s College of

Catbalogan, Catbalogan City Samar, as such, I was issued a college diploma by
said school and such, it was kept at home along with other important documents;

2. Sometime on March 17, 2021, however, as I was inspecting my

papers at their locations, I discovered that said diplomas were partially consumed,
damaged, and mutilated due to house termites much to my dismay and surprise;

3. Notwithstanding my efforts to reconstitute said diploma, the same

proved futile such that I consider it useless for all intents and purposes;

4. This statement is made in good faith and never intended to defraud

the government, the school, specifically, St. Mary’s College of Catbalogan,
Catbalogan City, Samar, and third persons;

5. I am executing this statement to attest the truth of all the foregoing

and to request for re-issuance of said college diploma from St. Mary’s College of
Catbalogan, Catbalogan City, Samar, and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 2 nd day of June 2023 at

Catbalogan City.

IVAN KIM D. SACAGUING

Affiant

SUBSCRIBED AND SWORN to before me this 2 nd day of June 2023 at Catbalogan City,
affiant exhibiting to me his DL ID No. H01-12-001119.
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF SAMAR………..….) SS
CITY OF CATBALOGAN………..…)

AFFIDAVIT OF LOSS

I, TWINKLE SHEEN M. EUFRACIO, of legal age, single, Filipino, and a resident of Brgy.
1, Motiong, Samar, after having been duly sworn to in accordance with law do hereby depose
and state: THAT-

6. In March 2017, I graduated my high school at the Motiong

National High School, Motiong, Samar, as such, I was issued high school
diploma by said school, and such, and such it was kept at home along with other
important documents;

7. Sometime in January 2020, however, as I was inspecting my

papers at their locations, I discovered that said diploma were no longer in my
envelope or I might have misplaced them somewhere else, and notwithstanding
repeated efforts to locate them, the same proved futile, such that I now consider
them lost for all intents and purposes;

8. This statement is made in good faith and never intended to defraud

the government, the school, specifically, Motiong National High School, Motiong,
Samar, and third persons;

9. I am executing this statement to attest the truth of all the foregoing

and to request for re-issuance of said high school diploma from Motiong National
High School, Motiong, Samar, and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 12 th day of May 2023 at

Catbalogan City.

TWINKLE SHEEN M. EUFRACIO

Affiant

SUBSCRIBED AND SWORN to before me this 12 th day of May 2023 at Catbalogan City,
affiant exhibiting to me her PhilHealth ID No. 13-251531413-3.
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF SAMAR………..….) SS
CITY OF CATBALOGAN………..…)

AFFIDAVIT OF LOSS

I, FLORILYN D. ARRIVADO, of legal age, single, Filipino and a resident of Brgy.

Candugue, Daram, Samar, after having been duly sworn to in accordance with law do hereby
depose and state: THAT-

1. I am a transferee student from Samar State University, Catbalogan City, taking up

Bachelor of Elementary Education; as such, I was issued transcript of records (TOR)
by said school and submitted for my enrollment at Samar Colleges, Inc., Catbalogan
City;

2. Sometime in May 2021, however, the Office of the Registrar, Samar Colleges,
claimed that while collating my papers at their records, it was discovered that said TOR was no
longer in the filing cabinet or might have been misplaced somewhere; and notwithstanding their
efforts to locate it, the same proved futile, such that I now consider said TOR lost for all intents
and purposes;

3. This statement is made in good faith and never intended to defraud the Samar State
University and third persons;

4. I am executing this statement to attest the truth of all the foregoing and to request for
reissuance of said college TOR from Samar State University, Catbalogan City, and for other
legal purposes

IN WITNESS WHEREOF, I hereunto affix my signature this 16 th day June 2022 at

Catbalogan City.

FLORILYN D. ARRIVADO
Affiant

SUBSCRIBED AND SWORN to before me this 16 th day June 2022 at Catbalogan City,
affiant exhibiting to me her TIN 364-625-274-000.