Republic of the Philippines)

City of Batangas
) S.S.

AFFIDAVIT OF LOSS
I, ALVIN MENDOZA y DE LA ROSA, single, of legal age, Filipino
citizen and with residence and postal address at Aplaya, San Jose, Tingloy,
Batangas, after having been duly sworn to in accordance with law hereby
deposes and says that:
1 I attended a training for seafarer on November 22, 2014 at THE
MARITIME TRAINING CENTER OF THE PHILIPPINES (TMTCP) at
Kalaw, Malate, Manila;
2 After the said training I was issued three (3) Certifications,
namely; Update BT with COP, SDSD with COP and Yellow Card
Vaccine;
3 I kept the said Certifications inside my cabinet in my house;
4 Yesterday when I was about to get the said Certifications for
purpose of inquiring from my agency the date of my departure for
abroad I could not find the said document;
5 I have exerted diligent efforts to locate the same but to no avail,
the said Certifications appear to have been irretrievably lost;
6 I am executing this Affidavit of Loss to attest the truth of the
foregoing, to inform THE MARITIME TRAINING CENTER OF THE
PHILIPPINES (TMTCP) of the facts surrounding the loss and further
for whatever legal purpose this may serve.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto set my hand this 13th
of June 2015 at City of Batangas.

day

ALVIN MENDOZA y DE LA ROSA

Affiant
SUBSCRIBED AND SWORN to before me this 13th day of June
2016 at City of Batangas, affiant presenting to me his Voters ID No.
VIN:1033-0040A-B1784ADM10004-5
Doc. No: 183;
Page No: 38;
Book No: IX;
Series of 2015.
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