Republic of the Philippines )

Alubijid, Misamis Oriental ) S.S.

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

AFFIDAVIT OF LOSS

I, Filipino of legal age, and residing at, Misamis Oriental, after being duly sworn to in
accordance with law, depose and state that:

1. I was a student of International School for Hotel and Restaurant Management

from years 2011 - 2014, and I was issued an OJT Certificate on May 2014

2. Sometime this year, I discovered that the said certificate was missing

3. After diligently and exhausting all efforts to produce said document, I could
not find nor locate the same is now lost beyond recovery.

4. As such, I am executing this affidavit in relation my request for the re-

issuance of said Certificate and for whatever legal purposes that this affidavit
may serve.

5. I executed this affidavit to attest to the truth of the foregoing statements.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day of September 2023, at
Alubijid, Misamis Oriental, Philippines

___________________
Affiant

SUBSCRIBED AND SWORN to before me this, at Alubijid, Misamis Oriental, Philippines.

Affiant exhibiting to me his Driver’s License issued by LTO bearing ID no.: competent
proof of identity.

Doc No. ____;

Page No. ____;
Book No. ____;
Series of ____