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Affidavit of Lost ATM

The document is an Affidavit of Loss for an ATM card issued by Union Bank of the Philippines. The affiant states that the card was lost after it got stuck in an ATM machine on January 23, 2025, and they have made efforts to retrieve it without success. The affidavit is executed to confirm the loss for legal purposes and includes a declaration to surrender the card if found.

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Rose Sebua (themesbyraininheaven)
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21 views1 page

Affidavit of Lost ATM

The document is an Affidavit of Loss for an ATM card issued by Union Bank of the Philippines. The affiant states that the card was lost after it got stuck in an ATM machine on January 23, 2025, and they have made efforts to retrieve it without success. The affidavit is executed to confirm the loss for legal purposes and includes a declaration to surrender the card if found.

Uploaded by

Rose Sebua (themesbyraininheaven)
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}

MUNICIPALITY OF MALABON } S.S.


METRO MANILA }

AFFIDAVIT OF LOSS ATM CARD


I, _______________________ of legal age, Filipino and resident of
_______________________________, under oath depose and say that –

1. That I am a depositor of Union Bank of the Philippines (ICTSI – Branch)


MICT South Access Road G/F ICTSI Administration Bldg, Manila, 1012.

2. That the aforesaid Bank issued to me an ATM Card under Account


No._______+

3. However, sometime on anuary 23, 2025, 9:30 am at PNB ATM machine


inside of University of the East Caloocan, after I update, my ATM Card got
stuck inside the ATM Machine.

4. I exerted diligent effort to locate said ATM Card, but proved futile, hence, I
considered it already lost and beyond retrieve.

5. I hereby bind myself to surrender the said ATM Card in the event that the same
is found or located.

6. I am executing this affidavit to attest the truth of the foregoing for all legal
intents and purposes.

IN WITNESS WHEREOF, I affixed my signature this________ day of


January 2025 at Malabon, Metro Manila.

_____________________
Affiant

SUBSCRIBED AND SWORN to before me this _______ day of January 2025 with
Affiant affixing his signature in my presence and within my notarial jurisdiction and
exhibiting to me his competent evidence of Identity bearing his photograph and
signature (under Section 6 and 12, Rule II of the 2004 Rules on Notarial Practice)
which I verified to be current and valid.

NOTARY PUBLIC

Doc No.
Page No.
Book No.
Series of 2025

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