Scribd
Upload
89 views2 pages

Affidavit of Loss - Blank

This affidavit of loss was sworn by an individual in Makati City, Philippines. It states that the affiant owned an item issued by an unnamed organization, but that the item was misplaced sometime in the past. Despite searching diligently, the affiant was unable to find the lost item and believes it cannot be recovered. The affiant further attests that the lost item was not confiscated by any authority or surrendered to a third party. The purpose of the affidavit is to inform and report the loss for any legal purpose.

Uploaded by

ric rele
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
89 views2 pages

Affidavit of Loss - Blank

This affidavit of loss was sworn by an individual in Makati City, Philippines. It states that the affiant owned an item issued by an unnamed organization, but that the item was misplaced sometime in the past. Despite searching diligently, the affiant was unable to find the lost item and believes it cannot be recovered. The affiant further attests that the lost item was not confiscated by any authority or surrendered to a third party. The purpose of the affidavit is to inform and report the loss for any legal purpose.

Uploaded by

ric rele
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

REPUBLIC OF THE PHILIPPINES)

C ITYO F MAKATI ) S.S.

AFFIDAVIT OF LOSS

I, _______________________________, of legal age, Filipino, resident at


___________________________________, after having been duly sworn to in
accordance with law do hereby depose and state:

1. That I am the owner/holder of the _________________________


issued by ___________________________;

2. That sometime ________________________ the said item was


misplaced;

3. That despite the diligent search and efforts to locate the said item, I
could not find the same such that I now have reasons to believe
that it is now lost and can’t be recovered;

4. That the said item was not confiscated by nor surrendered to any
lawful authority, a third person or third person for whatever reason;

5. That I am executing this affidavit to attest to the truth and the


veracity of the foregoing statement in order to inform, to report and
request for whatever legal purpose it may serve.

AFFIANT FURTHER SAYETH NAUGHT

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of


______________ at Makati City.

Affiant

SUBSCRIBED AND SWORN to before me this ____ day of


______________ at Makati City, Philippines. Affiant exhibited to me
_______________________________.

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

You might also like