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Affidavit of Loss

This affidavit of loss was sworn by Harika Avestruz on [date] in Tacloban City. It states that Avestruz was the Admin Officer for an event from September 30 to October 2, 2015. Several documents related to the event, including guest folios, hotel certificates, statements of account, participant room lists, and receipts, were sent via courier but have since been misplaced and cannot be found as of February 12, 2016. The affidavit was executed to attest to the truth of these facts.

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charmaine carating
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48 views1 page

Affidavit of Loss

This affidavit of loss was sworn by Harika Avestruz on [date] in Tacloban City. It states that Avestruz was the Admin Officer for an event from September 30 to October 2, 2015. Several documents related to the event, including guest folios, hotel certificates, statements of account, participant room lists, and receipts, were sent via courier but have since been misplaced and cannot be found as of February 12, 2016. The affidavit was executed to attest to the truth of these facts.

Uploaded by

charmaine carating
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES )

City of _______________________ ) S.S

AFFIDAVIT OF LOSS

I, HARIKA AVESTRUZ, of legal age and residing at No. 160 Avenida Veteranoz, Tacloban City,

under oath, state:

1. That I was the Admin Officer of the PLGP: Introduction of Bridging Leadership and Hospital Scorecard

Orientation for Eastern Samar last September 30 to October 2, 2015.

2. That as to my knowledge, there were no scanned IDs for the Event.

3. That after Event, the Guest Folio, Hotel Certificate, Statement of Account, Actual list of room for all the

participants, and Official receipt for 50% Downpayment and Full payment were sent via LBC Courier

were misplaced and cannot be found until today, February 12, 2016.

4. That I am executing this Affidavit to attest to the truth of the foregoing facts and to use the same for

whatever legal purpose it may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this _____________ day of February

2016 at Tacloban City.

HARIKA AVESTRUZ
Affiant
SUBSCRIBE AND SWORN to before me this _______________________ at

__________________, Affiant exhibiting to me his PHILHEALTH No.

Doc No. _______

Page No. ________

Book No. ________

Series of 2016

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