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Affidavit of Loss-Calzeda

This affidavit of loss was sworn by Roy Conrad T. Calzeda, a resident of Tagum City in the Philippines. He states that he is the holder of an SSS identification card with number CRN-0111-2085-249-6, but discovered it was no longer in his bag despite searching diligently. He executed this affidavit to inform the proper authorities that the card was lost so it could not be misused.

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Anisah Aquila
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36 views1 page

Affidavit of Loss-Calzeda

This affidavit of loss was sworn by Roy Conrad T. Calzeda, a resident of Tagum City in the Philippines. He states that he is the holder of an SSS identification card with number CRN-0111-2085-249-6, but discovered it was no longer in his bag despite searching diligently. He executed this affidavit to inform the proper authorities that the card was lost so it could not be misused.

Uploaded by

Anisah Aquila
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 Davao del Norte )


City of Tagum )S.S
x-------------------------x

AFFIDAVIT OF LOSS

I, ROY CONRAD T. CALZEDA, Filipino, married, of legal age and a


resident of Prk. Castrence , Tagum City, Davao del Norte, Philippines, after
having been duly sworn to in accordance with the law, do hereby depose
and say;

1. That I am a holder/owner/ possessor of an SSS Identification Card


bearing number CRN-0111-2085-249-6;

2. That I discovered that the said SSS Identification Card was no longer
found in my bag;

3. Despite diligent efforts to locate the said SSS Identification Card, the same
were proven futile;

4. I am executing this Affidavit to attest to the truth and veracity of the


foregoing statements and to apprise the proper authorities concerned
on the matter for their information, guidance and for whatever legal
purpose/s this may serve best.

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


__________________ at _________________________, Philippines.

ROY CONRAD T. CALZEDA Affiant

SUBSCRIBED AND SWORN to before me this _____ day of


________________________at ________________________, Philippines.

Doc. No. ____


Page No. ____;
Book No. ____;
Series of ____.

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