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Affidavit of Loss

1) The document is an affidavit of loss filed in the province of Tarlac, Philippines. 2) In it, the affiant states that they lost their Unified Multi-Purpose ID (UMID) issued by the Social Security System (SSS) when they left their wallet in a tricycle on a specific date while traveling home. 3) Despite efforts to find it, the UMID could not be located. The affiant asserts that the ID was not lost due to any legal violation and that the affidavit is being filed voluntarily, without coercion, to confirm the stated facts.

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Robert Quiambao
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54 views1 page

Affidavit of Loss

1) The document is an affidavit of loss filed in the province of Tarlac, Philippines. 2) In it, the affiant states that they lost their Unified Multi-Purpose ID (UMID) issued by the Social Security System (SSS) when they left their wallet in a tricycle on a specific date while traveling home. 3) Despite efforts to find it, the UMID could not be located. The affiant asserts that the ID was not lost due to any legal violation and that the affidavit is being filed voluntarily, without coercion, to confirm the stated facts.

Uploaded by

Robert Quiambao
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 )

Province of Tarlac ) S. S.

AFFIDAVIT OF LOSS

That I, ____________________________, of legal age, Filipino,


single and a resident of __________________________after having been
duly sworn to in accordance with law do hereby depose and say:

That I am a holder/possessor of an Unified Multi-Purpose ID (UMID)


with _________________________ issued by the Social Security System
(SSS);

That on ____________________, I lost my wallet which contained my


UMID when I was on my way home, probably left in the tricycle;

That I exerted diligent efforts to locate the same but it proved futile;

That it was not confiscated for any violation of the law;

That this affidavit is executed freely and voluntarily without any fraud,
duress, force and/or intimidation whatsoever but to confirm and affirm the
aforementioned facts as the basis of any legal intent and purpose it may
serve;

IN WITNESS WHEREOF, I have here unto set my hand this


_______________ day of ____________________ in the
____________________, Philippines.

___________________________________
Affiant

SUBSCRIBED AND SWORN to before me on the date and place first


above written.

Doc. No.___
Page No.___
Book No. ___
Series of 2019.

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