REPUBLIC OF THE PHILIPPINES }
MALABON, METRO MANILA } S.S.
AFFIDAVIT OF LOSS
I, ___________________ , of legal age, Filipino, with residence and
postal address at __________________________________ ____________, after having
been duly sworn to in accordance with law hereby depose and state that:
1. I am presently employed with _________________________ as
Messenger;
2. By virtue of my employment, I was issued an Identification Card;
3. Said Identification Card was lost sometime on October 03, 2019
at ______________________________;
4. Hereunder are the facts and circumstances surrounding the loss of my
Identification Card:
During my visit to _____________________ my Identification card was
left with the security guard on duty, however, it was mistakenly released/
given to somebody else, the said security guard cannot identify to whom he
has released my ID card.
5. I made diligent search to recover the said Identification Card but proved
futile;
6. For all legal intents and purposes the said Identification Card is now
considered lost and beyond recovery;
7. I am executing this affidavit to attest to the truth of the foregoing and for
whatever legal purpose/s it may serve.
FURTHER AFFIANT SAYETH NAUGHT.
IN TRUTH THEREOF, I have hereunto set my hand this _____________ day of
___________________20__, at __________________________, Philippines.
__________________
Affiant
SUBSCRIBED AND SWORN to before me this ___________________ day of
______________________ 20__ , affiant exhibited to me his/her Residence Cert. No.
__________________ issued at ___________________ on ______________________.
NOTARY PUBLIC
Doc. No. ___________;
Page No. ___________;
Book No. ___________;
Series of 20___
HF-HRD-AOL
