REPUBLIC OF THE PHILIPPINES)

Glan, Sarangani Province ) S.S.

AFFIDAVIT OF LOSS
I, CHRISTY Z. MANGGARON, of legal age, Filipino, single and a resident
of Tagumpay, Poblacion, Alabel, Sarangani Province, Philippines, after having
first been duly sworn to in accordance with law, do hereby depose and say that:

1. I am the lawful owner of a Form 137-A duly issued by Alabel National High
School.

2. I inadvertently misplaced said item and despite earnest efforts to locate

the same, it could no longer be found;

3. I now declare it lost and beyond recovery; and

4. I am executing this affidavit to attest to the truth of the foregoing facts for
all intents and purposes this may legally serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4th day

of March, 2019 at Glan, Sarangani Province, Philippines.

CHRISTY Z. MANGGARON
Affiant
S. No. _________

SUBSCRIBED AND SWORN to before me this 4th day of March, 2019 at

Glan, Sarangani Province, Philippines, affiant exhibited to me her valid
identification card indicated below her name.

DOC. NO.__________;
PAGE NO.__________;
BOOK NO.__________;
SERIES OF 2019.