Affidavit of Loss Sample

1 AFFIDAVIT OF LOSS

I, Ms. Aidi Marice Nofuente, Filipino, of legal age and a resident of Sucat, Muntinlupa City, after being sworn to in accordance with the law, do hereby depose and say: 1. That I am an alumnae of Polytechnic Polytechnic University of the Philippines-Sta. Philippines-Sta. Mesa. 2. That as such alumnae, was issued an Identification Card with the student no. 2k4025056-8 and a claim stub for Diploma and Transcript of Records. 3. That said Identification card and claim stub was in my possession from the time of  issuance but sometime on November 18, 2009 Wednesday or thereabout, the same was lost and notwithstanding diligent efforts, the same cannot be recovered or located. 4. That I am executing this affidavit to attest the truth and for whatever legal purpose it may serve.  _______  ___________ _______ _______ ________  ____  Ms. Aidi Marice Nofuente Affiant

SUBSCRIBED AND AND SWORN to before b efore me this thi s 11th day of April 2012 in Sta. Mesa, Manila.

Doc. No.______; Page No.______; Book No.______; Series No. 2009.