Republic of the Philippines)

Province of South Cotabato) S.S.

City/Municipality of Sto. Nio)
x - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, SANDRA S. ESPARTERO, of legal age, Filipino, single , and a resident of Barangay
Ambalgan, Sto. Nio, South Cotabato, Philippines, after having been duly sworn in
accordance with law, hereby depose and state:
1. That this year, 2014, I was issued by the Professional Regulation Commission,
Davao City a Claim Stub for the issuance of my PRC ID;

2. That recently I had tried to look for the said Claim Stub but the same could not
be found;


3. That despite diligent search and efforts to locate, I could not find the same such
that I now believe it is now lost beyond recovery;
As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support for the issuance of my PRC ID.
IN WITNESS WHEREOF, I have hereunto set my hand this 22
nd
of March at Sto.
Nio, South Cotabato, Philippines.

SANDRA S. ESPARTERO
Affiant




SUBSCRIBED AND SWORN TO BEFORE ME, a Notary Public for and in Sto.
Nio, South Cotabato this 24
th
day of March by the affiant, who personally appeared
before me and whose identity I have confirmed through her Community Tax
Certificate No. 08585134 issued on January 14, 2014 at Sto. Nio, South Cotabato.

Doc. No. ___
Book No. ___
Page No. ___
Series of 2014






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Book No. ____
Page No. ____
Series of 2011
SUBSCRIBE AND SWORN TO BEFORE ME, this 24
th
of March 2013 at Sto. Nio,
South Cotabato, Philippines affiant exhibits to me her community Tax Certificate, with her name
and signature.