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Affidavit of Loss: Wallet & IDs

Daisy Ann S. Gambong executed an Affidavit of Loss stating that on March 03, 2016 she noticed her wallet was missing while in Labangon. Her wallet contained her Access Card for EXL Service Phil, her key for pedestal #500, and her SSS ID. Despite searching diligently, she was unable to find her lost wallet and believes it was inadvertently lost. She executed the affidavit to request new replacements for her lost items.

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193 views1 page

Affidavit of Loss: Wallet & IDs

Daisy Ann S. Gambong executed an Affidavit of Loss stating that on March 03, 2016 she noticed her wallet was missing while in Labangon. Her wallet contained her Access Card for EXL Service Phil, her key for pedestal #500, and her SSS ID. Despite searching diligently, she was unable to find her lost wallet and believes it was inadvertently lost. She executed the affidavit to request new replacements for her lost items.

Uploaded by

JurilBrokaPatiño
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

CITY OF CEBU
) S.S.
x--------------------------------/.

AFFIDAVIT OF LOSS

I, DAISY ANN S. GAMBONG, of legal age, Filipino, single and a resident of Blk 2,
Lot 27, Deca Homes, Phase 2, Talisay City, after having been duly sworn to in accordance with
law, depose and state THAT :
1. Last March 03, 2016, I was somewhere at Labangon when I noticed that my wallet was
not in my bag;
2. My wallet contains my Access Card of EXL Service Phil bearing no. 94028, my key
for pedestal #500, and my SSS I.D bearing no 0925102960;
4. Efforts were exerted to locate the same, but in spite of diligent search, it could not be
found creating a belief that I probably inadvertently lost it somewhere which is now beyond
recovery ;
5. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and
for the purpose of issuance of a new access card, key for pedestal #500 and SSS I.D.
IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of March, in Cebu
City, Philippines.
DAISY ANN S. GAMBONG
Affiant
SUBCRIBED AND SWORN TO before me this 10th day of March 2016 in Cebu
City, Philippines, affiant exhibiting to me her competent evidence of identity by way of
a_______________________issued at __________________issued on __________________.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of ______.

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