Republic of the Philippines)
City of __________………….)S.S.
AFFIDAVIT OF LOSS
I, ______________, of legal age, Filipino, single, and a resident of ______________,
after being duly sworn according to law, hereby depose and state that:
1. I am an employee of _____________ and a holder of company identification
(ID) card bearing my employee number ___________;
2. On _______, I remembered giving my company ID to the hotel receptionist
when I checked in. As I forgot if it was handed back to me, I went back to the
hotel to ask for it. However, the hotel and I could no longer trace the
whereabouts of my company ID.
3. I exerted diligent efforts to locate, find and recover the company ID, but it
yielded negative results and to the best of my knowledge, the same were truly
lost;
4. The said company ID card was not confiscated by any authorities or by the
company.
5. I am executing this Affidavit to attest to the truth of the foregoing statements
and to support my request for the issuance of a replacement company ID
Card.
IN WITNESS WHEREOF, I have hereunto set my hand this ______________ at ______________,
Philippines.
______________________
Affiant
SUBSCRIBED AND SWORN to before me this _____________, in ___________, affiant exhibited
to me her Competent Evidence of Identity by way of _______________________ issued by
_____________.
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of 2018.