Scribd
Upload
57 views1 page

Affidavit of Loss Riña

The affidavit details a lost wallet containing important identification cards and an ATM card. The individual reported the incident but was unable to find the wallet. The affidavit is being made to facilitate issuing a replacement passbook for the lost one.

Uploaded by

Dang Joves Boja
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
57 views1 page

Affidavit of Loss Riña

The affidavit details a lost wallet containing important identification cards and an ATM card. The individual reported the incident but was unable to find the wallet. The affidavit is being made to facilitate issuing a replacement passbook for the lost one.

Uploaded by

Dang Joves Boja
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
You are on page 1/ 1

Republic of the Philippines )

Davao del Norte ) S.S.


City of Tagum )
x--------------------------------------------x

AFFIDAVIT OF LOSS

I, Jayvee Silagan Riña, of legal age, Filipino, single, and a resident


of 1485 Purok A Suaybaguio district, Tagum City, Davao del Norte, under
oath depose and say that:

1. Sometime on March 12, 2017, I lost my wallet;

2. Aside from money, inside that wallet contains important


Identification Cards such as my LTO I.D., Unified Multi-Purpose
I.D., Voter’s I.D., and my B.P.I ATM Card;

3. I have already reported such incident to the competent authority


but unfortunately it is still in no avail;

4. In spite of diligent search, I still could not find said wallet


containing those important information; and

5. That I am executing this affidavit to attest to the truth of the


foregoing statements and to facilitate the issuance of a new
passbook to replace the one I lost.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


_____th day of March, 2017 at Tagum City, Davao del Norte, Philippines.

Jayvee Silagan Riña


Affiant

SUBSCRIBED AND SWORN to before me on this ____ day of March,


affiant exhibiting to me sufficient evidence of his identity.

Witness my hand and seal.

Doc. No.: ___________;


Page No.: ___________;
Book No.: ___________;
Series of 2017.

You might also like