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Affidavit of Loss CR: I, Nikki Lou U. Densing, of Legal Age, Filipino, Single and A

Nikki Lou U. Densing has lost the official receipt and certificate of registration for her Honda motorcycle. She swears in this affidavit that the documents were misplaced despite efforts to find them, and that they were not transferred, encumbered, or confiscated. She takes responsibility if the lost documents are used improperly, and executes this affidavit to support her request for duplicate copies from the Land Transportation Office.

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Maeven E. Tubayan
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218 views2 pages

Affidavit of Loss CR: I, Nikki Lou U. Densing, of Legal Age, Filipino, Single and A

Nikki Lou U. Densing has lost the official receipt and certificate of registration for her Honda motorcycle. She swears in this affidavit that the documents were misplaced despite efforts to find them, and that they were not transferred, encumbered, or confiscated. She takes responsibility if the lost documents are used improperly, and executes this affidavit to support her request for duplicate copies from the Land Transportation Office.

Uploaded by

Maeven E. Tubayan
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 CAGAYAN DE ORO      ) S.S.
x----------------------------x
  

AFFIDAVIT OF LOSS CR 

 I, Nikki Lou U. Densing , of legal age, Filipino, single and a
resident of #28 Zone 8 Cugman, Cagayan de Oro City, after
having been duly sworn to in accordance with law, depose and
state THAT:

1. I am the registered owner of a motor vehicle which is particularly


described as follows:
    
             Make & Type :  HONDA MOTORCYCLE
  Motor Number : XRM18026270             
Chassis Number : XRM18EO26281
             Plate Number : 9111KV
             MV File No. : 
             Year Model/Color : :XRM OR FRAME/RED

2. As proof of ownership of the above-described vehicle I was issued


by the Land Transportation Office, Official Receipt (OR) and
Certificate of Registration (CR);

3. The said documents while in my possession were misplaced and


could no longer be located in spite of diligent efforts to locate
them;

4. Said documents were neither transferred to other


persons/entity/financial institutions for any consideration nor
encumbered to guarantee financial obligations with any financial
institution;
5. Said documents were not confiscated by any
government authorities for violation of R.A. 4136 and other
related laws;

6. I shall assume responsibility or liability if in any event I will use


these documents for whatever illicit transactions;

7. I am executing this affidavit to attest to the veracity of my


statements and to support my request for duplicate copies of the
lost MVRR/MVMRR/OR/CR with the Land Transportation Office
(LTO).

IN WITNESS WHEREOF, I have hereunto set my hand


this ___________________ in Cagayan de Oro
City, Philippines.

____________________
Affiant
SSS ID No. _____________

 SUBCRIBED AND SWORN TO before me


this ___________________ in
_________________, Philippines, affiant exhibiting to me his/her
competent evidence of identity by way of __________________
issued at ______________ on __________________.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2021.

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