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REPUBLIC OF THE PHILIPPINES }

PROVINCE OF EASTERN SAMAR }


MUNICIPALITY OF DOLORES }


AFFIDAVIT OF LOSS

I, LYNN T. ABELLA, a Head Teacher In-Charge of Dapdap National Technical Vocational
High School, Dolores Eastern Samar, after having duly sworn to in accordance with law, hereby depose
and say:
1. That I was requested by my teachers and students to borrow textbooks for our reference in
the conduct of our classer citations, accomplishing homeworks and assignments.
2. Those days after the opening of the school year, I noticed that some of the students were no
longer bringing/using their books during their class recitations/activities. I found out later that they lost
their borrowed books because their homes were flooded due to typhoon Pablo last December 24, 2012
causing widespread destruction to properties and the situation was beyond our control.
3. That upon this writing, I found out that the following textbooks were lost and could no longer
be found:
90 copies Integrated Science I
90 copies Ventures in Communication I
90 copies Elementary Algebra, Revised Edition I
90 copies Enjoy Life with Music and Arts I
90 copies Pilipinas Isang Sulyap at Pagyakap I
5 copies Sibol ng Karunungan I
60 copies Biology II
5 copies Sibol ng Karunungan II
70 copies Chemistry III
36 copies Physics IV
60 copies English Expressways II
4. That I was caused to execute this affidavit in order to establish the fact foregoing textbooks
were actually lost by my students and the same was not purposeful and intentional.
IN TRUTH HEREOF, I hereunto set my hand this 10
th
day of April 2013 at Dolores, Eastern
Samar Philippines.

LYNN T. ABELLA
Affiant

CTC No. 02296175
Issued on: 01-24-13
Issued at: Dolores E. Samar


...............................................................................

SUBSCRIBED AND SWORN TO before me this 10
th
day of APRIL, 2013 affiant
established her CTC no. 02296175 issued on January 24, 2013 at Dolores Eastern Samar, Philippines