Republic of the Philippines)

City of Cagayan de Oro )S.S.

X - - - - - - - - - - - - -/

AFFIDAVIT OF LOSS

I, GLENN ALEXIE A. GABUTAN, of legal age, Filipino, married and a

resident of Tibasak, Macasandig, Cagayan de Oro City after having been duly
sworn to law, hereby depose and say:

1. That I am a High School Graduate of Corpus Christi High School,

Macasandig, Cagayan de Oro City last March 31, 2005 - thus I was issued a
High School Diploma of the foregoing school;

2. That I keep the foregoing High School Diploma in my filing cabinet

in our house at Tibasak, Macasandig, Cagayan de Oro City, however, on the
night of December 16, 2011, Typhoon Code Name “Sendong” came and struck
the city and badly hit our house and damage all of my personal documents
including the said High School Diploma;

3 That I am executing this affidavit to attest to the veracity of the

foregoing facts and statements in order to facilitate for the issuance of a new
High School Diploma and for whatever legitimate purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of

February 13, 2023 at Cagayan de Oro City, Philippines.

GLENN ALEXIE A. GABUTAN

-Affiant-
DL No. M02-08-000033

SUBSCRIBED AND SWORN TO before me this 13th day of February

2023, at Cagayan de Oro City, Philippines, affiant known to me on the basis of
satisfactory evidence to be the same person who executed this affidavit.

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