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Republic of The Philippines) CITY OF - ) S.S. Affidavit of Loss Know All Men by These Presents

This affidavit of loss was sworn by [name] who states that: 1) They are the holder of a license that they cannot now locate 2) The license went missing sometime in [month, year] 3) Despite diligent efforts, they have been unable to find the lost license The affidavit was signed and notarized on [date] to attest to the truth of the statements made regarding the lost license.

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Amer Tago
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67 views1 page

Republic of The Philippines) CITY OF - ) S.S. Affidavit of Loss Know All Men by These Presents

This affidavit of loss was sworn by [name] who states that: 1) They are the holder of a license that they cannot now locate 2) The license went missing sometime in [month, year] 3) Despite diligent efforts, they have been unable to find the lost license The affidavit was signed and notarized on [date] to attest to the truth of the statements made regarding the lost license.

Uploaded by

Amer Tago
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 _______________ ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, ______________________________, of legal age, Filipino, single, and a resident


of ____________________________________, after having been sworn in accordance with
law, hereby deposes and states the following:

1. I am a holder of a ____________________.

2. Sometime in _________________, I noticed that the said license is missing.

3. I exerted diligent efforts to locate the said item, however I could no longer locate
the same. Thus, I consider it lost for all legal intents and purposes.

4. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purposes it may serve.

IN WITNESS HEREOF, I hereby affix my signature this _________________ in


_________________.

_________________
Affiant

SUBSCRIBED AND SWORN TO before me on the date and place indicated


above, the Affiant exhibited to me his _________________, valid until
_________________, as his competent evidence of identity, and known to me to be the
same person who executed the foregoing instrument and attested that the same is his
voluntary act and deed.

Doc. No. ___:


Page No. ___:
Book No. ___:
Series of 2020.

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