Sample Affidavit of Loss of a Diploma

Republic of the Philippines) Pasig City )S.S AFFIDAVIT OF LOSS I, _____________________, of legal age, and with office address at __________________l, under oath, hereby depose and say, that: 1. That I am a graduate of Doctor of Medicine the University of East Ramon Magsaysay Medical Center, Manila in 1990. 2. That I was issued a Diploma by said University. 3. That said Diploma was missing and must have been lost sometimes in March 2012 when there was a renovation/extension of our residential house. Despite long and diligent it could no longer be recovered. 4. I am executing this Affidavit to attest to the truth of the foregoing and to support a request for replacement copy of the above-mentioned Diploma. AFFIANT FURTHER SAYETH NAUGHT. IN WITNESS WHEREOF, I have hereunto affixed my signature this 24 day of July, 2013 th

_______________________________ Affiant

SUBSCRIBED AND SWORN to before me in Pasig City this 24 th day of July, 2013 by ____________________, who has satisfactorily proven to me her identity through __________ with number ______________ issued at ___________ valid until ______________. Doc. No. _____; Page No. _____; Book No. _____; Series of 2013.