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Affidavit of Mutilation 2019-2

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JULIE NOVALES
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12 views1 page

Affidavit of Mutilation 2019-2

agbvfcx

Uploaded by

JULIE NOVALES
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 ) S.S
x x

AFFIDAVIT OF DESTRUCTION/ MUTILATION

I, , of legal age, single/married/widow,


Filipino citizen, and presently residing at , after
having been duly sworn to in accordance with law, do hereby depose and say

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


by the Department of Foreign Affairs in ;

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 and therefore I request the Philippine Embassy/ Consulate to issue
a replacement passport in my favor; and,

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

IN WITNESS WHEREOF, I have hereunto set my hand this day


of 2019 at , Philippine Embassy Washington, D.C.

Affiant

SUBSCRIBED AND SWORN to before me this day of


2019 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 2019 Notary
Public

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