AFFIDAVIT OF LOSS
I, ATTY. RANE T. MONTESCLAROS, Filipino, of legal age, married, and a resident of
7-D Guadalajara Village, Guadalupe, Cebu City, after having been duly sworn in accordance with
law, hereby depose and say:
1. That I am the owner of the following described motor vehicle:
Make and type ………………….. TOYOTA COROLLA 1.6G AT
Motor No ………………….. 3ZZ-4809252
Chassis No ………………….. MR053ZEE106122912
Model ………………….. 2008
Plate No ………………….. YGX 308
Color ………………….. 1F8 MEDIUM SILVER METALLIC
MV File No.
2. That in that capacity, I was issued a Certificate of Registration and Official Receipt for the
said vehicle by the Land Transportation Office Cebu City District Office;
3. That I kept the said Certificate of Registration and Official Receipt inside my safe cabinet
in my office together with some important documents on file;
4. That recently, I discovered the loss of the said Certificate of Registration and Official
Receipt;
5. That I have exerted diligent effort to locate the said registration Certificate and Official
Receipt, but all my efforts were in vain;
6. That said motor vehicle has never been sold nor encumbered;
7. That this affidavit is executed to establish the foregoing facts and to support my request for
the issuance of a New Certificate of Registration and Official Receipt in lieu of the lost one.
IN WITNESS WHEREOF, I hereby signed this instrument this ____ day of September, 2015
in the City of Cebu, Philippines.
ATTY. RANE T. MONTESCLAROS
Affiant
SUBSCRIBED AND SWORN to before me, this ____ day of SEPTEMBER, 2015 in the City
of Cebu, Philippines. Affiant exhibited to me her CTC # __________issued in
_____________________ on ___________________.
Doc. No._____;
Page No._____;
Book No._____;
Series of 2015