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Philplan Affidavit of Loss

The affidavit states that the affiant is the planholder of a pre-need plan with PhilPlans First Inc. with a specific plan number. The plan was fully paid as of a certain date and the affiant was provided a Certificate of Full Payment, but has since misplaced their copy of the certificate. Despite searching diligently, the affiant was unable to locate their lost certificate. The affiant is executing this affidavit to attest that the certificate is lost and to support their application for a new copy of the certificate to be issued.

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Mary Annalyn Munar
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1K views1 page

Philplan Affidavit of Loss

The affidavit states that the affiant is the planholder of a pre-need plan with PhilPlans First Inc. with a specific plan number. The plan was fully paid as of a certain date and the affiant was provided a Certificate of Full Payment, but has since misplaced their copy of the certificate. Despite searching diligently, the affiant was unable to locate their lost certificate. The affiant is executing this affidavit to attest that the certificate is lost and to support their application for a new copy of the certificate to be issued.

Uploaded by

Mary Annalyn Munar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AFFIDAVIT OF LOSS

I, _______________________________________, of legal age, and having been duly sworn


in accordance with law, hereby state the following:

1. I am the Planholder of record of a pre-need plan (the “Plan”), entered into by


contract with PhilPlans First Inc. (PhilPlans), with Plan No.
____________________________.

2. Said plan has been fully paid on [date] and PhilPlans provided me with a
Certificate of Full Payment (the “Certificate”) with reference no. [number].

3. When asked to present my copy of the Certificate in order to avail of certain


benefits from PhilPlans, I realized that I had inadvertently misplaced my copy;

4. Despite a diligent and exhaustive search for my copy of the Certificate, I was
unable to locate it, and must assume that it is now lost and irretrievable;

5. I am executing this Affidavit to attest to the truth of the foregoing, to support my


application for a new copy of the Plan to be issued, and for whatever other official
and lawful purposes it may serve.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto signed these presents on this _____ day of
______________________ 2011 in _________________________________.

__________________________________
Affiant

REPUBLIC OF THE PHILIPPINES )


_________________ CITY ) S.S.

SUBSCRIBED AND SWORN to before me this _____ day of


_________________________________ in ________________________, affiant exhibiting to
me the following proof of identity:

Doc. No. ____


Page No. ____
Book No. ____
Series of _______.

th
8 Floor, PhilPlans Corporate Center, Kalayaan Avenue, Triangle Drive, Fort Bonifacio, Taguig City

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