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Affidavit of Loss (Id)

Sirah May I. Alvarez filed an affidavit of loss stating that she is the holder of an SSS identification card that has been irretrievably lost despite diligent efforts to locate it. She executed the affidavit to attest to the truth of the foregoing. The affidavit was subscribed and sworn to before a notary public on the date and place indicated, where the affiant exhibited competent evidence of her identity.

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Karla Alvarez Tan
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54 views1 page

Affidavit of Loss (Id)

Sirah May I. Alvarez filed an affidavit of loss stating that she is the holder of an SSS identification card that has been irretrievably lost despite diligent efforts to locate it. She executed the affidavit to attest to the truth of the foregoing. The affidavit was subscribed and sworn to before a notary public on the date and place indicated, where the affiant exhibited competent evidence of her identity.

Uploaded by

Karla Alvarez Tan
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 )

___________________________) S.S.

AFFIDAVIT OF LOSS
KNOW ALL MEN BY THESE PRESENTS:
I, SIRAH MAY I. ALVAREZ of legal age, Filipino, single, and a resident of MONTILLA
ST. BRGY ZONE 2, PULUPANDAN NEGROS OCCIDENTAL, after having been sworn in

accordance with law, hereby deposes and states the following:


1. I am holder/owner of the SSS identification card.
2. I have recently discovered the said item is irretrievably lost and can no longer be
found despite diligent efforts to locate the same;
3. I execute this affidavit to attest to the truth of the foregoing. Signed on the date
and at the place indicated below.

Affiant
(Signature over Printed Name)
ID:
issued on:
at:
SUBSCRIBED and SWORN TO before me on the date and at the place indicated
below. The affiant exhibited to me his competent evidence of identity as indicated
above.
Signed this ______________at ________________, ______________________,
Philippines.
WITNESS MY HAND AND SEAL.

Notary Public
Doc. No.
Page No.
Book No. I
Series of

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