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Affidavit of Loss - Draft

The document is an Affidavit of Loss executed by an individual in Valenzuela City, Philippines, declaring the loss of their ID. The affiant confirms efforts to locate the lost document and states it has not been confiscated or surrendered. The affidavit is sworn before a Notary Public on November 15, 2021.

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atty. jovay Antonio
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35 views1 page

Affidavit of Loss - Draft

The document is an Affidavit of Loss executed by an individual in Valenzuela City, Philippines, declaring the loss of their ID. The affiant confirms efforts to locate the lost document and states it has not been confiscated or surrendered. The affidavit is sworn before a Notary Public on November 15, 2021.

Uploaded by

atty. jovay Antonio
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
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REPUBLIC OF THE PHILIPPINES )

CITY OF VALENZUELA ) S.S

AFFIDAVIT OF LOSS

I, _______________________________, of legal age, single, Filipino, with


residence at ______________________________, do hereby depose and aver
that:

1. I am a holder of __________ ID bearing number _________ issued by


________________;

2. Sometime in __________________, my _________________ was lost/misplaced


somewhere at __________________________;

3. I exerted effort to look for the said documents but to no avail;

4. The aforementioned document has not been lawfully confiscated by any


appropriate government authorities nor surrendered to any person for
whatever purposes;

5. I am executing this statement to attest to all the above facts and for
whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of


November 2021 in the City of Valenzuela.

__________________________
Affiant

SUBSCRIBED AND SWORN to before me, this 15th day of November 2021 at
Valenzuela City, affiant being personally known to the Notary Public, presentation of
ID is dispensed with.

DOC. NO. ____;


PAGE NO. ____;
BOOK NO. ____;
SERIES OF 2021.

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