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Affidavit of Loss: Nurse's ID

Faith Joy Parilla Choresca executed an Affidavit of Loss to attest that she lost her hospital identification card. She was driving her motorcycle on December 3, 2021 in Cordova, Cebu when she believes she may have dropped her ID card. Despite searching, she was unable to find the lost card. She is submitting this affidavit to support her application for a new identification card to replace the one that was lost.

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Apple Joy Collados
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109 views1 page

Affidavit of Loss: Nurse's ID

Faith Joy Parilla Choresca executed an Affidavit of Loss to attest that she lost her hospital identification card. She was driving her motorcycle on December 3, 2021 in Cordova, Cebu when she believes she may have dropped her ID card. Despite searching, she was unable to find the lost card. She is submitting this affidavit to support her application for a new identification card to replace the one that was lost.

Uploaded by

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

CITY OF LAPU-LAPU ) S.S.

AFFIDAVIT OF LOSS

I, FAITH JOY PARILLA CHORESCA, of legal age, Filipino and a resident


of Calawisan, Lapu-Lapu City, Cebu, Philippines, after having been sworn to in
accordance with law, hereby depose and say:

1. That I am currently working as a NURSE at ARC Hospital and was


consequently issued a Hospital Identification Card;

2. That sometime December 3, 2021, I was driving my motorcycle along the


road of Cordova, Cebu. I remember having placed my ID in one of the side
pockets of my bag;

3. That upon reaching my destination, I noticed that my ID is no longer inside


the side pockets of my bag and was afraid that I might have dropped it
while driving;

4. That I tried to locate the said Identification Card but to no avail as the
same were lost and I could no longer find the same.

5. As such, I am executing this Affidavit of Loss to attest to the truth of the


foregoing and to support my application for the issuance of a new
Identification Card, in lieu of the one that I lost.

IN WITNESS WHEREOF, I have hereto set my hand this 13th day of


December 2021 at Lapu-Lapu City, Philippines.

FAITH JOY PARILLA CHORESCA


Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 13th day of


December 2021 at Lapu-Lapu City, Philippines. Affiant exhibited to me her
government issued ID as her competent proof of identity.

Doc No. :_____;


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

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