Republic of the Philippines)Province of SORSOGON) S.S.City/Municipality of SORSOGON)x - - - - - - - - - - - - - - - - - - - - - - - x

AFFIDAVIT OF LOSS

I, MAUREEN D. HUET, Filipino, of legal age, and a resident of Brgy. Rizal, Casiguran, Sorsogon, Philippines, after being duly sworn in accordance with law, depose and state:

1. That I am a student of Sorsogon State College-SITE, Cogon, Sorsogon City SY 2014-2015 ;2. That I was issued an enrollment form by the said school on October 27, 2014;3. That I kept the said enrollment form in our house at Brgy. Rizal, Casiguran, Sorsogon;4. That sometimes on November 2014, when I looked for the said enrollment form, I could no longer find the same;5. That despite diligent effort to locate the said document, the same was to no avail; and6. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing facts, and for whatever legal intents it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this July 7, 2014 at Sorsogon City, Philippines.MAUREEN D. HUETAffiant

SUBSCRIBED AND SWORN to before me, this ___________by the Affiant, known to me to be the same person who executed this affidavit and who is personally known to me.

Doc. No.____Page no.____Book No.____Series of 2015