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Affidavit of Loss: Republic of The Philippines - S. S. Done: in The City of Baguio

The document is an affidavit of loss filed by Domiciano F. Villahermosa stating that he lost his Philippine passport and is applying for a new one. He details finding his sling bag missing which contained his passport. He confirms the passport was neither confiscated nor relinquished. He is executing this affidavit to support his new passport application with the DFA and for any other lawful purposes.

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Antonio Manaligod
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106 views1 page

Affidavit of Loss: Republic of The Philippines - S. S. Done: in The City of Baguio

The document is an affidavit of loss filed by Domiciano F. Villahermosa stating that he lost his Philippine passport and is applying for a new one. He details finding his sling bag missing which contained his passport. He confirms the passport was neither confiscated nor relinquished. He is executing this affidavit to support his new passport application with the DFA and for any other lawful purposes.

Uploaded by

Antonio Manaligod
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

DONE: IN THE CITY OF BAGUIO

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S. S.

AFFIDAVIT OF LOSS
I, DOMICIANO F. VILLAHERMOSA, of legal age, married, Filipino citizen,
and with address at No 50 Purok 11, Bakakeng North, Baguio City, Philippines,
after being sworn in accordance with law, hereby depose and state
1. I am a holder of a Philippine Passport issued by the Department of Foreign Affairs
[DFA] in Baguio City.
2. Yesterday, December 20, 2016, at around 11:00 oclock in the morning, I
discovered that my sling bag containing my Philippine Passport was missing. A
copy of Police blotter report is hereto attached.
3. All my efforts to retrieve my Philippine Passport was in vain; hence, for all legal
intents and purposes it is now deemed lost and beyond recovery. I certify and
confirm that the said Philippine Passport was neither confiscated nor relinquished
in favour of any government institution, office, agency or entity.
4. I attest to the truth of the foregoing statements to the best of my own personal
knowledge and based on authentic documents and records. I am executing this
Affidavit of Loss to support my application with the Department of Foreign Affairs
[DFA] Baguio City for the issuance of a new Philippine Passport as well as for all
other lawful intents and purposes it may serve.
IN WITNESS WHEREOF, I set my hand this 3rd day of August 2016 at
Baguio City, Philippines.

HENRY ZUNIGA MANGUSAN


Affiant
VIN: 1108-2016A-C0386HZM10000
SUBSCRIBED AND SWORN to before me this 21st day of December
2016 at Baguio City, Philippines.

ATTY. VIOLAINE C. WYCOCO


Notary Public
N.A.26-NC-15-R
Until December 31, 2016
IBP No. 0724948 01.05.2016 Baguio City
PTR No. 2447081 01.05.2016 Baguio City
MCLE Compliance No. V-0000135; 07.20.2013
Doc. No. 13
Page No. 13
Book No. I
Series of 2016

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