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Affidavit of Loss: Republic of The Philippines) Caloocan City, Metro Manila) SS

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Jennifer Vinluan
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114 views1 page

Affidavit of Loss: Republic of The Philippines) Caloocan City, Metro Manila) SS

Uploaded by

Jennifer Vinluan
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)

Caloocan City, Metro Manila) SS

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, Jennifer T. Vinluan of legal age, Filipino, single/married, and a resident of


0034 (LT) E, Phase. Blk 28A St., Phase III-F1, Dagat-dagatan, Caloocan City , after having
been sworn in accordance with law, hereby deposes and states the following:

1. I am holder/owner/ or possessor of the following identification card / document:


PRC Identification Card (Card Number: 1547165)

2. I have recently discovered the said item/s is/are irretrievably lost and can no longer
be found despite diligent efforts to locate the same;

3. I execute this affidavit to attest to the truth of the foregoing. Signed on the date and

at the place indicated below.

JENNIFER T. VINLUAN
(Signature over Printed Name)
Competent Evidence of Identity
ID:
issued on:
at:

SUBSCRIBED and SWORN TO before me on the date and at the place indicated below.
The affiant exhibited to me his competent evidence of identity as indicated above.

Signed this ________________ at _________________________,_________________,


Philippines.

WITNESS MY HAND AND SEAL.

Notary Public

Doc. No.
Page No.
Book No. 1
Series of

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