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Affidavit of Loss - Diploma

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REPUBLIC OF THE PHILIPPINES }

CITY OF MALOLOS, BULACAN } S.S.

AFFIDAVIT OF LOSS

I, ____________, of legal age, Filipino, single and residing ______________, after


having been duly sworn in accordance with law, hereby certify:

1. That I am a graduate of Marcelo H. Del Pilar National High School with school address
at Marcelo H. Del Pilar Avenue, Malolos, Bulacan;

2. That I was issued a Diploma by the said school;

3. That recently while looking for the aforesaid Diploma in our residence where it was
being kept, it was discovered that the said Diploma was missing. It was probably
disposed inadvertently during the general cleaning of our house;

4. That all efforts are exerted to locate the same but to no avail and that to the best of my
knowledge and information, said Diploma is now beyond recovery;

5. That I have executed this affidavit to attest and confirm the truth of all the foregoing and
to be used for all legal intents and purposes it may serve.

FURTHER AFFIANT SAYETH NAUGHT

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in


the City of Malolos, Bulacan.

__________________
Affiant

SUBSCRIBED AND SWORN TO before me this ___________________ in the City of


Malolos, Bulacan.

Doc. No.________
Page No. _______
Book No. _______
Series of 2021.

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