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Affidavit of Loss: Ma. Belen R. de Loso

Ma. Belen R. De Loso filed an affidavit of loss stating that on August 15, 2019 while at work in CEPZA, Rosario, Cavite, her company identification card and zone pass identification card were missing and could not be found despite efforts to locate them. She executed the affidavit to report the loss to her employer and obtain replacement cards. The affidavit was sworn before a notary on September 12, 2019 in Tanza, Cavite, Philippines.

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1K views1 page

Affidavit of Loss: Ma. Belen R. de Loso

Ma. Belen R. De Loso filed an affidavit of loss stating that on August 15, 2019 while at work in CEPZA, Rosario, Cavite, her company identification card and zone pass identification card were missing and could not be found despite efforts to locate them. She executed the affidavit to report the loss to her employer and obtain replacement cards. The affidavit was sworn before a notary on September 12, 2019 in Tanza, Cavite, Philippines.

Uploaded by

messageforjason
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 CAVITE ) S. S.
MUNICIPALITY OF TANZA )

AFFIDAVIT OF LOSS

I, MA. BELEN R. DE LOSO, of legal age, Filipino, married and a resident of


Blk 11 8 ACM Woodstock Homes, Barangay Sanja Mayor, Tanza, Cavite, after
having been sworn in accordance with law, hereby depose and state that:

1. I am employee of Reliance Producers Cooperative., CEPZA, Rosario,


Cavite;

2. On August 15, 2019, while I was inside CEPZA, Rosario, Cavite


premises company identification card and zone pass identification card issued by
the aforesaid company is no longer in my possession and is missing;

3. The circumstances leading to the loss of said card has not been
determined;

4. Up to this day, the whereabouts of said card remained unknown


despite diligent efforts to recover the same and the same may now be
considered lost for all intents and purposes;

5. I am executing this affidavit to attest to the foregoing facts and for


the purpose of reporting the fact of loss of said card to the company, to secure
the issuance of another in lieu of the lost one and for any legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 12th day of


September, 2019, in the Municipality of Tanza, Province of Cavite, Philippines.

MA. BELEN R. DE LOSO


Affiant

SUBSCRIBED AND SWORN to before me this 12th day of September, 2019, in the
Municipality of Tanza, Province of Cavite, Philippines, affiant exhibiting to me her
VOTERS ID NO. 2120-0156A-12573MRD20006-7 with photograph and signature
through which I had been able to confirm her identity.

ATTY. JASON ALMOND P. DE GUZMAN


Notary Public-Province of Cavite
Commission Expires Dec. 31, 2020
IBP Roll No. 61387
MCLE No. VI– 0019537; 03-01-19
PTR No. 1751077; Cavite; 1-07-19
IBP Lifetime Member Roll No: 018800
PPLM; 01-03-18
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2019.

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