Sei sulla pagina 1di 1

REPUBLIC OF THE PHILIPPINES)

CITY OF MANILA
)S.S.

AFFIDAVIT OF LOSS
I, MARK JAYSON LLORIN, of legal age, Filipino, and resident of
Block 101 Lot 28, Sunshine Ville, Cabuco, Trece Martires City, Cavite, after
having been duly sworn to in accordance with law, hereby depose and say
that:
1. I was an student of Philippine Normal University;
2. As such an student,
UG201400034

was

issued

an

School

ID

No.

3. That inadvertently, said


School ID No. UG201400034 was
inadvertently lost by me while I was inside the PNU campus on
October 26, 2016.
4. Despite of diligent efforts to look for said school ID, all such efforts
proved futile and in vain, thus, I am declaring the loss of my said
school ID.
5. I am executing this affidavit to attest to the truth of the foregoing
facts for all its legal intents, effects, consequences and purposes.

MARK JAYSON LLORIN


Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this 2nd day of


November 2016 at the City of Manila
Doc. No. 294
Page No. 60
Book No. 1
Series of 2016.

Potrebbero piacerti anche