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Affidavit of Loss

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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF TARLAC ) S.S.


TARLAC CITY )

AFFIDAVIT OF LOSS

I, ANGEL RONALENE R. BAUTISTA, of legal age, Filipino citizen, and


a resident of Tarlac City, after having been duly sworn to in accordance with law
do hereby depose and states THAT:

1. That I am a holder of a Student ID issued by Tarlac State University;

2. That the said Student ID went missing;

3. Despite diligent efforts exerted to locate the same, it could no longer be


found and is now deemed lost and beyond recovery;

4. I am executing this affidavit to attest to the truth of the foregoing statements


and for all legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


______________ day of __________________ in Tarlac City, Philippines.

ANGEL RONALENE R. BAUTISTA


Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicate


above, Affiant exhibited to me her identification card as indicated below her name.

Doc. No. __________;


Page No.__________ ;
Book No.__________;
Series of 2023.

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