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REPUBLIC OF THE PHILIPPINES )

Province of Leyte )
Municipality of Villaba ) S.S.
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AFFIDAVIT OF LOSS
I, MA. LOURDES S. CARATAO, of legal age, married, Filipino, and a resident of Brgy.
Cagnocot, Villaba, Leyte, Philippines, after being duly sworn to in accordance with law, hereby
depose and state:

1. That I am a licensed Professional Teacher with PRC License No. 1092112 and is
currently teaching at Villaba National High School (VNHS), Cagnocot, Villaba, Leyte;

2. That I applied for the renewal of my PRC ID with the Professional Regulation
Commission (PRC), Tacloban City, Leyte, which issued a CLAIM SLIP supposedly to be
presented to the PRC upon my claim of my renewed PRC ID;

3. That sometime on July 22, 2018, I misplaced the said CLAIM SLIP that was issued to
me by PRC, Tacloban City, Leyte;

4. That despite diligent search and efforts to locate the said CLAIM SLIP, I could not find
it such that I now believe that it is now lost beyond recovery;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and
for whatever legal purpose/s that it may best serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of July, 2018 at
Villaba, Leyte, Philippines.

__________________________________
MA. LOURDES S. CARATAO
AFFIANT

SUBSCRIBED AND SWORN to before me, this 3rd day of July, 2018 in Villaba, Leyte,
Philippines, by MA. LOURDES S. CARATAO, who is personally known to me and who exhibited
her TIN ID Card with No. 426-515-308-000 issued on 09/11/2012 by BIR, Ormoc City, Philippines

NOTARY PUBLIC

Doc. No. 454;


Page No. 92;
Book No. XII;
Series of 2018.