AFFIDAVIT OF LOSS
I, GABRIEL PAULO R. UY, of legal age, Filipino citizen, and resident of unit 1207 Grand towers tower 2
Pablo Ocampo St., Malate, Manila, Philippines, after being duly sworn in accordance with law, hereby
depose and state under oath:
1. That I am the lawful owner/holder of the following lost item/document: Operation brotherhood
Montessori High School Diploma.
2. That the lost item/document was in my possession and custody, and I have exercised due care
and diligence to keep it safe and secure.
3. That I have made a diligent search and inquiry to locate the lost item/document but to no avail. It
is irretrievably lost and cannot be recovered.
4. That the loss of the said item/document was not due to any negligence, willful act, or omission on
my part.
5. That I am executing this Affidavit of Loss to attest to the truth of the foregoing facts and for the
purpose of applying for the issuance of a new/replacement item/document.
IN WITNESS WHEREOF, I have hereunto set my hand this 16th of January, 2024, in Manila City,
Philippines.
_______________________
Gabriel Paulo R. Uy
SUBSCRIBED AND SWORN to before me this 16th of January 2024, in Manila City, Philippines,
affiant exhibiting competent evidence of identity through Philippine Passport with number
P9917327A, issued on 13 December 2028.
WITNESS MY HAND AND SEAL.
Notary Public
311
Doc. No. _____;
41
Page No. _____;
XX
Book No. _____;
Series of 2025.