Republic of the Philippines )

City of Iloilo ) s.s

AFFIDAVIT OF LOSS OF SCHOOL IDENTIFICATION CARD

I, Ruzzel Diane Oducado, Filipino, of legal age, single and a resident of 123 Jalandoni St.,

Jaro, Iloilo City, after having been duly sworn in accordance with law, hereby depose and say:

1. That I am a holder of a school identification card bearing ID number 05-1357-95

issued by Central Philippine University;

2. That I used to put said identification card in my wallet;

3. That sometime on February 29, 2016, when I arrived home from school, I discovered

that my school ID card was no longer in my wallet where I used to place it;

4. That I might have inadvertently dropped the said school ID card when I dished out

money from my wallet for jeepney fare;

5. That I am executing this affidavit to attest to the truth of the foregoing facts and to

request for a replacement of said school ID card.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8th day of March

2016 in Iloilo City, Philippines.

RUZZEL DIANE I. ODUCADO Affiant

SUBSCRIBED AND SWORN TO before me this 8th day of March 2016 in Iloilo City. The

affiant, whom I identified through the following competent evidence of identity: Postal ID, valid

from January 2015 to January 2017 issued by Philippine Post Office, personally signed the

foregoing instrument before me and avowed under penalty of law to the whole truth of the

contents of said instrument.

ATTY. MAYREN P. ABUCIONNotary PublicUntil December 31, 2015PTR No. 1234567IBP No. 58637Roll No. 123456MCLE Compliance No. 000123

Doc. No.___;Page No. ___;Book No. ___;Series of 2016.