Republic of the Philippines)

Roxas City )
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AFFIDAVIT OF LOSS

I, NENITA B. CANDELARIO of legal age, Filipino, single, and

a resident of Brgy. Pangabuan, Jmaindan, Capiz, Philippines, after
being sworn in accordance with law, depose and say:

1. That I am a graduate of Bachelor of Science in

Agriculture having my Original College Diploma and
Alumni ID.

2. That the above-mentioned original were compiled in a

Folder for safekeeping but due to the accidental fire that
damaged our staff house which resulted to destruction
and damage of all the important documents including my
Original College Diploma and Alumni ID.

3. That after such discovery, I am exerted efforts in

retrieving the original copy of my diploma and alumni ID,
however, the same proved futile and fruitless.

4. That I am executing this affidavit to attest all the

foregoing facts are true and correct based on my
personal knowledge and for other purposes it serve me
best.

IN WITNESS WHEREOF, I have hereunto set my hand this

____________ in the City of Roxas, Capiz, Philippines.

NENITA B. CANDELARIO
Affiant

The affiant whose name and personal circumstances are

stated above, appeared in person before me this
__________________, in the City of Roxas, Province of Capiz,
presented the above instrument, signed the same in my presence,
and affirmed or swore under oath to the truth and correctness of
the contents or allegations of the same.

The affiant was personally known to me and she exhibited to

me his identification card no. ___________ issued at Jamindan, Capiz.

Doc. No. _____

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