REPUBLIC OF THE PHILIPPINES )
CITY OF PUERTO PRINCESA ) S.S.
AFFIDAVIT OF LOSS
1. I, ___________, of legal age, Filipino, single, and a resident
of__________________, Puerto Princesa City, under oath, in accordance with
law, depose and say that:
I am the owner of the car with the following details:
Engine No. :
MV File No. :
Model :
Plate No. :
Color :
2. Sometime in January 2025, while I was looking for the Certificate of
Registration of the above-mentioned car inside my wallet where it was
ordinarily placed, I noticed that the same was missing;
3. I exerted every possible effort to look for the said Certificate of
Registration but the same was proved futile, such that I consider the same as
lost and beyond recovery;
4. The said lost Certificate of Registration was never lent to another person
or entity, nor confiscated by any other law enforcement agency;
5. I am executing this affidavit to attest to the truth of the foregoing
statements and to consider the said Certificate of Registry as lost and
beyond recovery, so that I will be relieved of the responsibility to still return
the same.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
___________________ in Puerto Princesa City.
___________________
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this ____________________
in Puerto Princesa City, attesting that this affidavit was executed on his own
free will and deed.
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of 2025.
