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Affidavit of Loss Cash Card

Susana Maligaya filed an affidavit of loss stating that she lost her ATM cash card issued under the Pantawid Pamilyang Pilipino Program. She noticed her wallet, and the cash card within, were missing while traveling from Poblacion to Bulawan in Lapuyan, Zamboanga Del Sur on October 6, 2020. Despite searching, she was unable to find the lost card. She executed the affidavit to attest to the loss and request a replacement card.

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Santoy Cartalla
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2K views1 page

Affidavit of Loss Cash Card

Susana Maligaya filed an affidavit of loss stating that she lost her ATM cash card issued under the Pantawid Pamilyang Pilipino Program. She noticed her wallet, and the cash card within, were missing while traveling from Poblacion to Bulawan in Lapuyan, Zamboanga Del Sur on October 6, 2020. Despite searching, she was unable to find the lost card. She executed the affidavit to attest to the loss and request a replacement card.

Uploaded by

Santoy Cartalla
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)

MUNICIPALITY OF LAPUYAN..) S. S.
X - - - - - - - - - - - - - - - - - - - - -/

AFFIDAVIT OF LOSS

I, SUSANA H. MALIGAYA, of legal age, Filipino, married and a resident of Purok


Aticap, Tininghalang, Lapuyan, Zamboanga Del Sur, Philippines, having been duly
sworn to in accordance with law, do hereby depose and say:

1. I am a beneficiary of the Pantawid Pamilyang Pilipino Program or commonly


called 4ps of the Municipality of Lapuyan, of which I am issued an ATM cash
card;

2. Sometime on October 06, 2020, while I was traveling from Poblacion going to
Bulawan of the same Municipality, I noticed that upon reaching the said
Barangay, Bulawan, Lapuyan, Zamboanga Del Sur, I noticed that my wallet
where the cash card is placed is not in my possession anymore;

3. That despite diligent effort to locate the said ATM Cash Card, the same is
now beyond recovery;

4. That I am executing this affidavit to attest to the veracity of the above stated
facts and allegations and for the issuance of a ATM CASH CARD and for
whatever legal purposes it may serve best;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 9th day of


October 2020, at Lapuyan, Zamboanga Del Sur, Philippines.

SUSANA H. MALIGAYA
Affiant
4PS ID: 097313030-0631-00035

SUBSCRIBED AND SWORN to before me this 9th day of October 2020, at


Lapuyan, Zamboanga Del Sur, Philippines.

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