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Affidavit of Loss

PFC Jonard P Dimayacyac PAF affirms the loss of his CASH SURRENDER VALUE POLICY due to a super typhoon that struck Quezon Province in September 2018. The policy was received by his wife after he was assigned to a different location, and despite her efforts, it could not be recovered. This affidavit is executed for legal purposes to attest to the truth of the loss.

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Erika Vanessa Francelizo
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9 views1 page

Affidavit of Loss

PFC Jonard P Dimayacyac PAF affirms the loss of his CASH SURRENDER VALUE POLICY due to a super typhoon that struck Quezon Province in September 2018. The policy was received by his wife after he was assigned to a different location, and despite her efforts, it could not be recovered. This affidavit is executed for legal purposes to attest to the truth of the loss.

Uploaded by

Erika Vanessa Francelizo
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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AFFIDAVIT OF LOSS

I, PFC JONARD P DIMAYACYAC PAF, Filipino, married, of legal age and with
address at Leveriza Subdivision, Barangay Isabang, Tayabas City, after being into
accordance with do hereby depose and state:

1. That, I am a registered member of The Armed Forces and Police Mutual Benefit
Association, Inc. (AFPMBAI) and as such, I was issued last March 2018 a CASH
SURRENDER VALUE POLICY with Account No. 2017030660 which was sent to
my address at Barangay Abuyon, San Narciso, Quezon, Philippines;

2. That, upon receipt of the said Policy, I was assigned at Camp Panacan in Davao
City so that my wife, Alaiza T Dimayacyac received it on my behalf;

3. That, on September 2018, a super typhoon hit the Province of Quezon. Strong
winds devastated our residence and hence said policy and other documents kept
therein have lost;

4. That, right after the storm, my wife exerted all diligent efforts to locate the said
policy but the same proved to be futile and I believed that the same is beyond
recovery;

5. That, I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose this may serve

AFFIANT FURTHER SAYETH NAUGHT.

PFC JONARD P DIMAYACYAC PAF


Affiant

SUBSCRIBED AND SWORN to before me, this _______ day of March 2022 at Lucena
City. Affiant personally appeared and identified by me through competent evidence of
identity.

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