Republic of the Philippines)
Digos City, Davao del Sur) s.s.
x----------------------x
AFFIDAVIT OF LOSS
I, MARY G. LARIOSA, Filipino, of legal age, married, and a resident of Deca Homes,
Cabantian, Davao City, after being duly sworn to in accordance with law, hereby depose and
state:
That I am the same and identical person who caused for the execution of this Affidavit;
That I am a bonafide employee of San Pedro College of Davao City;
That, as such, I was issued with an ID card for identification purposes;
That I placed the said ID card on a neck sling and I regularly wear the same inside the
school premises;
That, just recently, I discovered that the ID card could no longer be found even in the
usual places where I put my personal things;
That despite diligent search and efforts to locate the said ID card, I could not find it
anymore such that I now believe that 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 my request for the issuance of a new ID Card, in lieu of the one that was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at
_____________, Philippines.
MARY G. LARIOSA
Affiant
SSS No. 0923876421
SUBSCRIBED AND SWORN to before me, this _____________, by the Affiant whom I
have identified through competent evidence of identity first above indicated.