Scribd
Upload
672 views1 page

Affidavit of Loss RD Receipts

Jayca C. Hermosa purchased a pair of earrings from RD Pawnshop in Gamay, Northern Samar for 7,550 pesos on May 10, 2022, as evidenced by receipt number PT#28085106. After purchasing the earrings, Jayca placed the receipt in her pocket and went home. When she later searched for the receipt, she discovered it was no longer in her pocket. Despite searching, Jayca was unable to find the lost receipt. As a result, Jayca executed an affidavit on June 6, 2022 to attest that receipt PT#28085106 was lost beyond recovery.

Uploaded by

mikhael Santos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
672 views1 page

Affidavit of Loss RD Receipts

Jayca C. Hermosa purchased a pair of earrings from RD Pawnshop in Gamay, Northern Samar for 7,550 pesos on May 10, 2022, as evidenced by receipt number PT#28085106. After purchasing the earrings, Jayca placed the receipt in her pocket and went home. When she later searched for the receipt, she discovered it was no longer in her pocket. Despite searching, Jayca was unable to find the lost receipt. As a result, Jayca executed an affidavit on June 6, 2022 to attest that receipt PT#28085106 was lost beyond recovery.

Uploaded by

mikhael Santos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 1

Republic of the Philippines )

Province of Northern Samar)


Municipality of Gamay )s.c.

AFFIDAVIT OF LOSS

I, JAYCA C. HERMOSA, of legal age, Filipino, single, and a resident of


Brgy. Oriental II, Gamay, N. Samar, under oath, hereby depose and state:

1. That on May 10, 2022, I bought, on installment basis, a pair of


earrings (1:Y6 earrings def. pair bicolor, 32 grams, 18k)
amounting to seven thousand five hundred fifty pesos
(P7,550.00) at the RD Pawnshop, Gamay, N. Samar, as
evidenced by PT#28085106.

2. That after receipt of the said Official Receipt (PT#28085106), I


placed it inside my pocket and went home.

3. That after an hour, when I was already looking for the said
Official Receipt (PT#28085106), I discovered that it was no
longer inside my pocket.

4. That despite earnest efforts to locate the said Official Receipt


(PT#28085106), I could no longer recover and locate it; thus, I
considered it now as lost and I am on my honest belief that it is
now beyond recovery.

5. That I executed this affidavit to attest the truth of the foregoing


statements and the fact of such loss, and for whatever legal
intents and purposes this may serve.

IN WITNESS WHEREFOF, I have hereunto set my hand this 6 th day of


June 2022, in Gamay, Northern Samar, Philippines.

JAYCA C. HERMOSA
Affiant

SUBSCRIBED AND SWORN to before me this 6 th day of June 2022, in


Gamay, Northern Samar, Philippines. The affiant exhibited to me her COMELEC
Identification Card, bearing her signature and photograph, as competent proof of
her identity.

You might also like