Juralyn Vegas (affidavit Of Lose).docx

Republic of the Philippines) CITY OF SAN PEDRO

) S.S

Province of Laguna

AFFIDAVIT OF LOSS I, Juralyn A. Vegas, of legal age, Filipino and with residential address at blk.12 . Barangay Milagrosa Phase 3-B Carmona, Cavite, after having been duly sworn to in accordance with law, hereby depose and say: 1. That I am the holder of the following:



NCAE Result

2. That, sometime on November 2017 the said Result were lost and after diligent search it was nowhere to be found and presumed lost;

3. That, I am executing this affidavit in order to attest the truth of the foregoing circumstances and for the purpose of reporting the loss to the proper authorities for whatever legal purpose it may serve; IN WITNESS WHEREOF, I have here unto set my hand and affix my signature below, this 26th of March, 2019 at the City of San Pedro Laguna. JURALYN A. VEGAS Affiant

SUBSCRIBED AND SWORN to before me this 26th day of March, 2019 in City of San Pedro Laguna. Affiant having exhibited to me her PhilHealth I.D with No.08-026046937-5 as competent proof of identity.

Doc. No: ____________ Page No.:____________ Book No.:____________ Series of 2018