Republic of the Philippines)

Province of Negros Oriental)s.s.

Municipality of Sibulan……)

AFFIDAVIT OF LOSS

THAT I, EDSEL P. LINEJAN, of legal age, Filipino, single and a resident of

Barangay Poblacion, Sibulan, Negros Oriental, under oath, do hereby depose and
manifest:

That I was a Fourth Year High School Student of Saint Paul University,
Dumaguete City for the School Year 2012-2013; and correspondingly, I was issued a
Student Identification Card of the said University;

That a week before our graduation last March 2013, the said Identification Card
issued by the said University got lost while riding in my motorcycle;

That the said Identification Card was placed in my pocket when I arrived home on
that day, I discovered that the said ID was already lost and could no longer be found ;

That I tried my best to locate the said Student ID but all my efforts were in vain,
the same could no longer be found;

That this affidavit is executed freely and voluntarily just to attest the truthfulness
and veracity of the allegations herein.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of

May 2013, at Sibulan, Negros Oriental.

EDSEL P. LINEJAN
(Affiant)

SUBSCRIBED AND SWORN to before me, this ___ day of May 2013, at
Sibulan, Negros Oriental.

TIRSO F. BANQUERIGO
Judge