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Affidavit of Loss: Republic of The Philippines) City of San Pedro, Laguna) S.S

Dante Manales Rivera Jr. filed an affidavit of loss to request reimbursement for a mattress and pillow he purchased for PHP1553.50 that was approved by his employer Monark Equipment Corporation. He bought the items on February 4, 2020 but lost the receipt. Despite searching, he was unable to find the lost receipt. Through this affidavit, he aims to have his employer process the reimbursement for the purchase.

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Jerica Machado
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228 views1 page

Affidavit of Loss: Republic of The Philippines) City of San Pedro, Laguna) S.S

Dante Manales Rivera Jr. filed an affidavit of loss to request reimbursement for a mattress and pillow he purchased for PHP1553.50 that was approved by his employer Monark Equipment Corporation. He bought the items on February 4, 2020 but lost the receipt. Despite searching, he was unable to find the lost receipt. Through this affidavit, he aims to have his employer process the reimbursement for the purchase.

Uploaded by

Jerica Machado
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

CITY OF SAN PEDRO, LAGUNA ) S.S.

AFFIDAVIT OF LOSS

I, DANTE MANALES RIVERA JR., Filipino, of legal age, single and a


resident of South Expressway, Corner Magsaysay Road, Barangay San Antonio,
San Pedro Laguna after having been duly sworn to in accordance with law do
hereby depose and state that:

1. I work as a Mechanic in Monark Equipment Corporation located in South


Expressway, Corner Magsaysay Road, Barangay San Antonio, San Pedro
Laguna.

2. Sometime on 04 Feb 2020, I bought items particularly a matress and a


pillow with a total worth of PHP1553.50 in Angela Shoppers Mall in
Mauban, Quezon.

3. Said purchase is approved and authorized by the Accounting


Department of Monark Equipment Corporation.

4. Unfortunately, the receipt for the said purchase is lost.

5. That upon diligent search and inquiry, the said receipt cannot be found.

6. I am executing this Affidavit to attest the truthfulness of the foregoing


facts and for the purpose of requesting the Accounting Department of
Monark Equipment Corporation to process my reimbursement with the
said purchase.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 5 th


day of March 2020 in the City of San Pedro Laguna.

DANTE MANALES RIVERA JR


Affiant
Philhealth ID 15-202336594-9

SUBSCRIBED AND SWORN TO before me this 5 th day of March 2020 at


the City of San Pedro, Laguna, affiant exhibited to me his Philhealth ID as
competent proof of his identity.

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2020.

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