Republic of the Philippines)

Province of Southern Leyte..) S. S.

Municipality of Macrohon )

AFFIDAVIT OF LOSS

I, RICHARD . SABANDAL, Filipino, of legal age, ___ and a resident of San Roque,
Macrohon, Southern Leyte, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and say:

1. That I am a bona fide alumni of San Roque, National, High School at San
Roque, Macrohon, Southern Leyte;

2. That relative thereto, a HIGH SCHOOL DIPLOMA was issued in my favour;

3. That undesirably however, the aforesaid HIGH SCHOOL DIPLOMA was lost
last year 2017, because my boarding house located at Tondo, Manila was
burned.;

4. That I have exerted my best efforts to locate and recover the aforesaid HIGH
SCHOOL DIPLOMA, but my efforts proved futile. I now consider the same
irretrievably lost;

5. That I am executing this affidavit to attest the veracity of the foregoing, and
for whatever legal purpose this may serves best.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 13 th day of

June 2018 at Macrohon, Southern Leyte, Philippines.

RICHARD . SABANDAL
Affiant

SUBSCRIBED AND SWORN TO before this 13th day of June 2018 at Macrohon,
Southern Leyte, Philippines, affiant exhibiting to me his ___________________________
as competent evidence of identity.

ATTY. MENCHIE ANN S. SALINAS

Notary Public
Com. No. 2017-10 UNTIL Dec. 31, 2018
Roll of Attorneys No. 66790
Doc. No. ____ IBP No. 021495; 1/05/18
Page No. ____ PTR No. 6073809; 1/04/18
Book No. ____ MCLE Compliance: Exempt
Series of 2018 Macrohon, Southern Leyte