Republic of the Philippines)
Mabalacat City, Pampanga) S.S.
                                  AFFIDAVIT OF LOSS
       I, WINNIE C. NUNEZ, of legal age, Filipino, single, with postal and residence
address at Dau, Mabalacat, Pampanga, after having been duly sworn in accordance with
law, do hereby depose and say:
   1. That I obtain my Bachelor’s Degree in Nursing at Central Luzon Doctors’ Hospital
      Education Institution;
   2. That after my graduation, I was issued my diploma;
   3. That, sometime last week, I was searching for my diploma within the premises of
      our house;
   4. That in spite of efforts to search for my diploma, I could not find the same;
   5. That I am executing this affidavit to be able to secure a diploma from Central Luzon
      Doctors’ Hospital Education Institution ;
   6. That I am executing this affidavit to attest to the truth of the foregoing statements
      and for other legal purposes it may serve.
      IN WITNESS WHEREOF, I have hereunto affixed my signature this 16 th day of
August 2019 in Mabalacat City, Pampanga, Philippines.
                                                                WINNIE C. NUNEZ
                                                                   Affiant
                                                                                                                   
       SUBSCRIBED AND SWORN to before me this 16th day of August 2019 in
Mabalacat City, Pampanga, the affiant who is personally known to me, personally signed
the foregoing instrument before me and acknowledged to me that she freely and
voluntarily executed the same.
                                                     ATTY. MISHEENA JOYCE C. TIATCO
                                                     Notary Public for Angeles City, Mabalacat City and
                                                     Municipalities of Porac and Magalang, Pampanga
                                                     Commission No. 2017-663, until December 31, 2019
                                                     Atty’s Roll No. 63340, IBP Lifetime Member No. 012612
                                                     PTR No. AC-1287101, 1/4/2019, Angeles City
                                                     Clark International Airport Corporation
                                                     MCLE Compliance No. VI-000486
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of 2019.