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Affidavit of Loss Atm Card

Rgine A. Diongzon filed an affidavit of loss stating that she lost her BDO ATM card after arriving home from work on June 1, 2019 when she discovered her wallet, which contained her ATM card, was missing from her bag which had been slashed. Despite searching, she was unable to find or recover her lost ATM card. She requests a new ATM card be issued in place of the lost one.

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Howard Untalan
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29K views1 page

Affidavit of Loss Atm Card

Rgine A. Diongzon filed an affidavit of loss stating that she lost her BDO ATM card after arriving home from work on June 1, 2019 when she discovered her wallet, which contained her ATM card, was missing from her bag which had been slashed. Despite searching, she was unable to find or recover her lost ATM card. She requests a new ATM card be issued in place of the lost one.

Uploaded by

Howard Untalan
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 Batangas )
x- - - - - - - - - - - - - - - - - - - - x

AFFIDAVIT OF LOSS

I, REGINE A. DIONGZON (Sorosoro Ibaba Development Cooperative), 28, Filipino, single and a
resident of Zone 2 Bilogo Batangas City, Philippines, after having been duly sworn in accordance
with law, hereby deposes and state:

1. That I am a holder BDO ATM Card with Account Number 003580460492 issued by
Banco De Oro(BDO) Batangas City;
2. That Sometime in June 1 2019, I lost my BDO ATM Card under the following
circumstances: Sometime in June 1, 2019, after arriving from office, I was just
surprised to have known that my wallet containing my BDO ATM card was already
missing as it might have been forcibly taken out from my bag which was then slashed
on its upper right side corner;
3. That despite diligent efforts exerted, I could no longer locate, find or recover my wallet
containing my BDO ATM card mentioned, and to the best of my knowledge, the same
is truly lost;
4. That said BDO ATM card has not been confiscated by any officer of the law or the
issuing office or agency due to the violation of any law, statute, order, rule or
regulation;
5. That in the event that the lost BDO ATM card should hereafter be found or located, I
undertake to forward or surrender the same to its issuing institution; and
6. That I am executing this affidavit to attest to the truth of the foregoing statement and
to request for the issuance of a new BDO ATM card mentioned in lieu of the one which
was lost.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ______ 2019 at
Batangas City, Philippines.

REGINE A. DIONGZON
AFFIANT

SUBSCRIBED AND SWORN to before me this ______ day of _______ 2019, affiant
exhibited to me his competent evidence of identity by way of ________________________
issued at ___________________________ on ________________________.

NOTARY PUBLIC

Doc No. __________ ;


Page No. __________;
Book No. __________;
Series of 2019.

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