AFFIDAVIT OF LOSS OF IDENTIFICATION CARD REPUBLIC OF THE PHILIPPINES ) _____________________________ ) SS.

I, Katrina Jean C. Miranda, Filipino, of legal age, single and a resident of 34 Alma Jose St. Zabarte Rd. Caloocan City, after having been duly sworn in accordance with law, hereby depose and say:

1. That I am a holder of a school/company identification card bearing serial number L-120203 issued by San Beda College of Law-Mendiola;

2. That I used to put said identification card in my bag, among others;

3. That yesterday, September 9. 2013, Monday, at around 1:00 pm while I was walking along Morayta Street, two male factors riding in a motorcycle appeared from behind and one of them forcibly took my bag containing some valuable gadgets together with my school ID.

4. Attached herewith is a police report regarding the incident.

5. That said school ID was not confiscated by the authorities of school by reason of any violation of school/company rules and regulations;

6. That I am executing this affidavit to attest to the truth of the foregoing facts and to request for a replacement of said school ID card from San Beda COL.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 8th day of July 2013 at Manila, Philippines.

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(Signature of Affiant over Printed Name)

SUBSCRIBED AND SWORN TO before me, a notary public in and for _____________________ this ____ day of ____________ 20___. The affiant, whom I identified through the following competent evidence of identity: (ID type and number), valid from (date) to (date) issued by (issuing authority), personally signed the foregoing instrument before me and avowed under penalty of law to the whole truth of the contents of said instrument.

Notary Public Doc. No. ..; Page No. .; Book No. .; Series of 2013.