Republic of the Philippines)

__________, _____________) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, _____________________, of legal age, Filipino, single, and a resident of

________________________________________, after having been duly sworn in accordance
with law, do hereby depose and state that:

1. I am an alumna of Rizal Technological University-Pasig.

2. As such alumna, I was issued an Alumni Identification card.

3. Sometime on February 2018, said ID was lost and notwithstanding diligent efforts, the
same cannot be recovered or located.

4. I am executing this affidavit to attest to the truth of the foregoing statements and for
all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ of ________ in

_____________, Metro Manila, Philippines.

_________________________
Affiant

SUBSCRIBED and SWORN TO before me on the date and at the place indicated below.
The affiant exhibited to me her competent evidence of identity by way of TIN No.
____________________________________

Notary Public

Doc. No. ____;

Page No.____;
Book No. ____;
Series of 2018