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REPUBLIC OF THE PHILIPPINES)

SURIGAO CITY) S.S.

AFFIDAVIT OF LOSS

I, MARIFE C. CURADA, of legal age, Filipino and a resident of Brgy. San Juan,
Surigao City, Surigao del Norte, Philippines after having been sworn to in accordance
with law, do hereby depose and state that:

1. I am the officer in charge of the 33 copies of the books: Science 10,


Edukasyon sa Pagpapakatao 10, Mathematics 10, Filipino 10, and English
10, issued by Pilipinas ng FEP Printing Corporation Department of
Education-Instructional Materials Council Secretariat (Dep-Ed-IMCS);
-PWEDE RA WAYA INI

2. That on February 13, 2018, storm Basyang have flooded Caraga Regional
Science High School;

3. That due to the said storm, the 33 copies of the 5 books assigned in class
GRADE 10 BOYLE have been lost;

4. That we have made efforts in finding the said books but to no avail;

5. I am executing this Affidavit to attest to the truth of the foregoing and for
whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this


____________________, at Surigao City.

MARIFE C. CURADA
Affiant

SUBSCRIBED AND SWORN TO before me this ________________ in Surigao City,


Philippines, the affiant exhibiting to me her __________________ issued on ________ at
____________.

Doc. No._____;
Page No._____;
Book No._____;
Series of 2018.