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Senior Citizen ID Loss Affidavit

Mario Estores, a senior citizen in Bacong, Negros Oriental, Philippines, executed an affidavit of loss regarding his OSCA ID with Control No. 3617 that was issued to him on June 22, 2016. In the affidavit, he attests that he had placed the ID in his pants pocket but discovered it was missing after a week. Despite searching, he was unable to find the lost ID. He signed the affidavit to affirm the truth of the facts regarding the lost ID.

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Gracelyn Enriquez Bellingan
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345 views2 pages

Senior Citizen ID Loss Affidavit

Mario Estores, a senior citizen in Bacong, Negros Oriental, Philippines, executed an affidavit of loss regarding his OSCA ID with Control No. 3617 that was issued to him on June 22, 2016. In the affidavit, he attests that he had placed the ID in his pants pocket but discovered it was missing after a week. Despite searching, he was unable to find the lost ID. He signed the affidavit to affirm the truth of the facts regarding the lost ID.

Uploaded by

Gracelyn Enriquez Bellingan
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 Dumaguete ) S.S.


x - - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF LOSS

I, MARIO ESTORES, of legal age, Filipino, and a resident of San Miguel


Bacong, Negros Oriental, after having been sworn in accordance with law,
hereby deposes and states the following that:

1. I a registered senior citizen in the barangay of San Miguel, Municipality


of Bacong, Negros Oriental;

2. I was issued my respective OSCA ID with Control No. 3617 last


06/22/16;

3. I have placed the said ID in one of the pockets of my pants. However,


just last week, when I was looking for the said ID, I discovered it was no
longer in any of my shorts;

4. Despite diligent search and efforts to locate my wallet with my ID, I could
no longer find the same;

5. That I am executing this affidavit to attest to the veracity of the foregoing


facts and for whatever legal purpose this may serve.

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


of _________ in Dumaguete City, Philippines.

MARIO ESTORES
ID No. _____________
Affiant

SUBCRIBED AND SWORN TO before me this _____________


in Dumaguete City, Philippines, affiant exhibiting to me his competent proof of
identification.

WITNESS MY HAND AND SEAL.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2018.

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