Republic of the Philippines}

City of Tagum………………………………….}S.S.
Province of Davao Del Norte}
x--------------------------x

AFFIDAVIT OF LOSS
I, JESELLE P. LAGRAMA, of legal age, Filipino, and with residence
address at Laak, Comval Province, Philippines, after having been
duly sworn according to law depose and say that:
1. I am one and the same person whose personal circumstance is
herein above described;
2. I am a former staff at the University of Southeastern
Philippines (USeP);
3. By virtue thereof, I was issued a USeP Library ID;
4. Recently, the aforesaid Library ID could no longer be found in
my possession;
5. I thereafter searched the said Library ID but despite diligent
effort exerted to search and locate it, my efforts proved
futile and in vain;
6. In view thereof, I hereby declare the aforesaid Library Card
as lost for all intents and purposes;
7. I am executing this affidavit in order to attest the truth of
the foregoing facts and to apprise the University of
Southeastern Philippines or any concerned entity of the facts
herein narrated and for whatever legal purpose/s this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 25 June

2019 at Tagum City, Davao del Norte, Philippines.

JESELLE P. LAGRAMA
Affiant

SUBSCRIBED AND SWORN to before me this 25 June 2019 at Tagum

City, Davao del Norte, Philippines, affiant exhibited to me her
competent evidence of identity in the form of her PASSPORT ID
No. P9735755A.

WITNESS MY HAND AND SEAL.

ATTY. JONATHAN P. UY
Notary Public
Until December 31, 2020
Doc. No.273; PTR No. 2250769; January 8, 2019
Page No._75; IBP OR # 006403; May 21, 2018
Book No._10; Roll No. 67339
Series of 2019 TIN No. 452-694-284