REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I,

GINA NADAL, of legal age, single, Filipino, and resident of Block 39

Lot 7, Bernabe Compound, Pulanglupa, Las Pinas City, after being duly sworn to
in accordance with law, hereby depose and say that:
I am the mother of JUANA CLARISSE NADAL, who graduated high school
batch 2013-2014 at Santiago G. Bernardo Foundation Inc., Pulanglupa, Las
Pinas City.
As such, she was issued Form 138 by the said school
Said Form 138 was inadvertently lost.
Inspite of our diligent efforts to look for said

Form 138 all such efforts

proved futile and in vain up to this time, thus, I am declaring the loss of the said
Form 138.
I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes.

GINA NADAL
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this June 17, 2014 at Las
Pinas City.
Doc. No. 315
Page No. 64
Book No. 83
Series of 2014.

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I,

CHRISTOPHER DAVE OMAMBAC, of legal age, single, Filipino, and

resident of Block 9 Lot 5, Topaz Ext., Manuela, Talon V,

Las Pinas City, after

being duly sworn to in accordance with law, hereby depose and say that:
1. I graduated high school batch 2010-2011 at Golden Acres National
High School.
2. As such, I was issued Form 138 by the said school
3. Said Form 138 was inadvertently lost.
4. Inspite of diligent efforts to look for said

Form 138 all such efforts

proved futile and in vain up to this time, thus, I am declaring the loss of the said
Form 138.
5. I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes.

CHRISTOPHER DAVE OMAMBAC

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this June 10, 2014 at Las
Pinas City.
Doc. No. 142
Page No. 31
Book No. 83
Series of 2014.

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I,

KYLE THOMAS DAVID, of legal age, Filipino, and resident of #34-A,

Romulus St., Garden Homes, BF Resort Village, Las Pinas City, after being duly
sworn to in accordance with law, hereby depose and say that:
4. I am a holder of a Honorable Dismissal issued by Benilde (DLS-CSB).
5. Said Honorable Dismissal issued by the said school inadvertently lost.

3. Inspite of diligent efforts to look for said

Honorable Dismissal, all such

efforts proved futile and in vain up to this time, thus, I am declaring the loss of
the said Honorable Dismissal.
4. I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes.

KYLE THOMAS DAVID

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this
Las Pinas.
Doc. No.

176

Page No.

36

Book No. 72
Series of 2013.

August 4, 2013 at

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I,

KIMBERLY SUZZANE DECENA, of legal age, Filipino, and resident of

Sunrise Sport St., Jen Bldg. 4 th Estate, San Antonio, Paranaque City, after being
duly sworn to in accordance with law, hereby depose and say that:
1. I graduated high school batch 2001 at Las Pinas East National High
School, Verdant Acres, Las Pinas City.
2. As such, I was issued a Form 138 by the said school.
6. Said Form 138 issued by the said school inadvertently lost/missing.

4. Inspite of diligent efforts to look for said

Form 138, all such efforts

proved futile and in vain up to this time, thus, I am declaring the loss of the said
Form 138
5. I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes.

KIMBERLY SUZZANE DECENA

Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this October 8, 2013 at
Las Pinas City.
Doc. No.

310

Page No.

63

Book No. 74
Series of 2013.