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Affidavit for Damaged Passport

The document is an affidavit of destruction/mutilation submitted by a Filipino citizen to request a replacement Philippine passport. It states that the individual's passport was damaged and rendered unusable due to unspecified reasons. It affirms that the damage occurred and requests a new passport be issued by the Philippine Embassy in Kuala Lumpur. The affidavit is signed and notarized.

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Dick Mark Bon Aguiling
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431 views1 page

Affidavit for Damaged Passport

The document is an affidavit of destruction/mutilation submitted by a Filipino citizen to request a replacement Philippine passport. It states that the individual's passport was damaged and rendered unusable due to unspecified reasons. It affirms that the damage occurred and requests a new passport be issued by the Philippine Embassy in Kuala Lumpur. The affidavit is signed and notarized.

Uploaded by

Dick Mark Bon Aguiling
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 DESTRUCTION/ MUTILATION

I, __________________________________, Filipino citizen, legal age, presently residing at


__________________________________________________________________________________
after having been duly sworn to in accordance with law, hereby depose and state:

1. That I am a holder of Philippine Passport No. ______________________ issued on


___________________ at _____________________;
2. That the said passport was damaged/ mutilated due to
____________________________________________________________________
____________________________________________________________________
__________________________________________________________________
3. That the damage on the said passport has rendered it unusable for travel purposes;
4. That I am requesting the Philippine Embassy in Kuala Lumpur to issue a replacement
passport in my favor; and

5. That I attest to the veracity of the foregoing information.

IN WITNESS WHEREOF, I hereby affix my signature this day of ______________________ at


____________________________.

___________________________
Affiant
(Full Name and Signature)

SUBSCRIBED AND SWORN to before me this day of ___________________________, at


________________________ affiant exhibiting to me his/ her valid proof of identification.

Doc. No. : ________


Service No.: ________
Book No. : ________
Series of : ________ __________________________
Fee Paid : ________ Consular Officer
O.R. No. : ________

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