I, ________________, of legal age, single, Filipino Citizen and a
resident of Baguio City, after having been duly sworn to in accordance with law do hereby depose and state:
1. That I am a third year medical student at Saint Louis University Baguio;
2. That I was issued a school ID card with No. ______; 3. That on ________, I discovered that my school ID card was missing. 4. That despite diligent efforts, I could no longer locate the same; 5. That said school ID card was not confiscated by the authorities of school by reason of any violation of rules and regulations; 6. That I further attest to the truth of all the foregoing facts and to request for a replacement of said school ID card.
IN WITNESS WHEREOF, I have hereunto set my signature this 9th day of
June 2018, in the City of Baguio, Philippines.
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of June, 2018 at
Baguio City, Philippines. Affiant personally appeared and vouched that all the foregoing declarations are true to the best of his personal knowledge.