Republic of the Philippines)
City of San Fernando ) S.S.
x---------------------------x
AFFIDAVIT OF LOSS
I, SHAIN ANN C. CASTILLO, of legal age, single, Filipino citizen, and a resident
of Brgy., Legaspi, San Manuel, Tarlac, after being duly sworn to in accordance with law,
depose and state that:
(1) That sometime on August 2018, I was looking for my Student Permit.
(2) That I have looked everywhere to find my Student Permit but it was nowhere
to be found;
(3) Diligent efforts to locate the same were exerted but it proved futile;
(4) I am executing this affidavit to attest to the truthfulness of the foregoing facts
and for what legal intents and purposes it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 8th day of June
2018 in Makati City.
MARIA C. DELA CRUZ
Affiant
SUBSCRIBED AND SWORNto before me this 8th day of June 2018 in the City of
Makati, Philippines, affiant exhibited to me her ________________as valid proof of
identity.
Doc. No. _____
Page No. _____
Book No. _____
Series of 2018.