Scribd
Upload
35 views1 page

Republic of The Philippines) ,) S.S.: Doc. No. Page No. Book No. Series of

This affidavit describes the loss of identification cards belonging to an individual. It states that the cards were stolen and provides basic details about the incident and the request to replace the stolen IDs and ATM card. The affidavit is signed by the individual and notarized to attest to the truth of the loss being reported.

Uploaded by

Aezy Rañola
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
35 views1 page

Republic of The Philippines) ,) S.S.: Doc. No. Page No. Book No. Series of

This affidavit describes the loss of identification cards belonging to an individual. It states that the cards were stolen and provides basic details about the incident and the request to replace the stolen IDs and ATM card. The affidavit is signed by the individual and notarized to attest to the truth of the loss being reported.

Uploaded by

Aezy Rañola
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
You are on page 1/ 1

Republic of the Philippines )

, ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, (name) of legal age, Filipino, (marital status), and a resident of (address), after having been
sworn in accordance with law, hereby depose and state the following:

1. I am the true and lawful owner of the following identification card:


State the description of the identification cards here.
2. That these aforementioned ID cards were stolen;
3. (describe briefly what transpired when the incident happened); and
4. I execute this affidavit to attest to the truth of the foregoing, and to request for a
replacement of the stolen ids and ATM card.

IN WITNESS WHEREOF, I have hereunto set my hand this______ Day of__________ at


__________________.

Affiant
(name)
Identification card

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.
Series of

You might also like