Republic of the Philippines)

Province of Southern Leyte) s.s.

Municipality of Tomas Oppus )
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AFFIDAVIT OF LOSS

I, RENDEL MANTILLA SACRO, of legal age, single, Filipino and a resident of

Brgy.Punong, Tomas Oppus, Southern Leyte after having been duly sworn to in
accordance with law, hereby depose and say:

1. That I am a student of Southern Leyte State University, San Isidro, Tomas Oppus,
Southern Leyte and as such I was issued with a school ID, bearing no: 16-10193;

2. That sometime in March 2019, the aforementioned School ID got lost and
nowhere to be found;

3. That exhaustive efforts were exerted to locate the same but my search proved
futile as I could not locate the same up to present;

4. That I executed this affidavit in order to attest to the truth and veracity of the
foregoing so that I may be issued another one and for whatever legal purpose this
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 21stday of March 2019 in
the Municipality of Tomas Oppus, Southern Leyte, Philippines.

RENDEL MANTILLA SACRO

Affiant
Driver’s License No. H11-18-000476

SUBSCRIBED AND SWORN to before me this 21stday of March 2019 in the

Municipality of Tomas Oppus, Southern Leyte, Philippines.