Republic
of the Philippines)
Province of Cebu )S.S.
Mandaue City )
x---------------x
AFFIDAVIT OF LOSS
I, JANET G. CUAMBOT, Filipino, of legal age, single and a resident of Banban,
Bogo City, Cebu, Philippines, after being duly sworn in accordance with law, depose
and state:
1. That I was a student of Southern Leyte State University, Sogod, Southern Leyte,
Philippines sometime on the year 2011;
2. That sometime on the year 2017, I requested my school records and I was issued;
3. However, the said school records while in my possession was misplaced and got
lost;
4. Efforts were exerted to locate the said school records however, it could not be
found and the same is now beyond recovery;
5. As such, I am executing this Affidavit of Loss to attest to the truth of the
foregoing facts.
IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at
Mandaue City, Cebu, Philippines.
JANET G. CUAMBOT
Affiant
SUBSCRIBED AND SWORN TO before me ______________ in Mandaue City,
Cebu, Philippines, affiant being personally known to me to be the same person who
executed the foregoing instrument.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2021.