Affidavit of Loss CR 2

Republic of the Philippines )
PROVINCE OF ISABELA ) s.s.

Municipality of Cauayan )
x- - - - - - - - - - - - - - - - - - - - - x
AFFIDAVIT
I, JAYSON BALAO ABORDO, of legal age, Filipino and a resident

of Magsaysay, Naguilian, Isabela after having been duly sworn to an
oath in accordance with law do hereby depose and say:
1. That I am the same person executing this affidavit;
2. That I and Sheena Mae Garcia Abordo (Sheena for brevity)

married each other on February 14, 2012 before Mayor Jing
Reyes of Alicia, Isabela;
3. That during our marriage together as husband and wife we

were blessed of three (3) children namely: Ayen Ayat Garcia,
Jayson G. Abordo, Jr. and Azimuth G. Abordo;
IN WITNESS WHEREOF, I have hereunto set my hand this 25nd day

of October, 2018 at Cauayan City, Isabela.
______________________
Affiant
SUBSCRIBED AND SWORN to before me this 25th day of October,

2018 at Cauayan City, Isabela.
Doc. No. ________

Page No. ________
Book No. ________
Series of 2018

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AFFIDAVIT OF LOSS
I, MARLON A. VILLANUEVA, of legal age, Filipino and a resident

of Magdalena, Cabatuan, Isabela after having been duly sworn to
an oath in accordance with law do hereby depose and say:

2. That I am owner of a certain motor vehicle more particularly
described as follows:
MAKE--------- --------------------- HONDA
Series------------------------------ CCG125WHF
Engine number ------------------- KSW00E236107
Chassis number ------------------ KSW00235521
Plate number --------------------- AZ15949
MV File number ------------------ 1401-11940
Model------------------------------- 2016
3. That sometime last month of this year when I go over all my files
from all my pertinent documents including the original
Certificate of Registration of the above-described vehicle, I
noticed that said document is already missing;
4. That original document was never been confiscated by any
traffic enforcement authorities for committing any violation nor
use as collateral to any lending institutions;
5. That I am executing this Affidavit to attest to the truth of all the
foregoing facts and to request the Land Transportation Office to
grant me duplicate copy of my Certificate of Registration.
IN WITNESS WHEREOF, I have hereunto set my hand this 17th day

of October, 2018 at Cauayan City, Isabela.
MARLON A. VILLANUEVA
Affiant
SUBSCRIBED AND SWORN to before me this 17th day of October,

2018 at Cauayan City, Isabela.
Doc. No. ________

Page No. ________
Book No. ________
Series of 2018
x- - - - - - - - - - - - - - - - - - - - - x
AFFIDAVIT OF LOSS
I, EMMANUEL SINGSON ANTALAN, of legal age, Filipino and a

resident of Brgy. San Fermin, Cauayan City, Isabela after having been
duly sworn to an oath in accordance with law do hereby depose and
say:

2. That I am the new owner of a certain motor vehicle more
particularly described as follows:
MAKE--------- --------------------- MITSUBISHI
Series------------------------------ CANTER
Engine number ------------------- 4D32-932275
Chassis number ------------------ FE305B-460895
MV File number ------------------ 0386-81164
Plate number ---------------------RAW275
Model------------------------------- 1900
3. That sometime last July 7, 2018 when I arrived home from Luna
to San Fermin, I noticed that I left my envelope from the tricycle
I hired which contains all my pertinent documents including the
original Certificate of Registration of the above-described
vehicle, I noticed that said document is already missing;
4. That original document was never been confiscated by any
traffic enforcement authorities for committing any violation nor
use as collateral to any lending institutions;
5. That I am executing this Affidavit to attest to the truth of all the
foregoing facts and to request the Land Transportation Office to
grant me duplicate copy of my Certificate of Registration.

of September, 2018 at Cauayan City, Isabela.
EMMANUEL SINGSON ANTALAN

Affiant
SUBSCRIBED AND SWORN to before me this 20thth day of
September, 2018 at Roxas, Isabela.
Doc. No. ________

Page No. ________
Book No. ________
Series of 2018

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AFFIDAVIT OF LOSS
I, MILLIE JOY MORENO ROMAN, of legal age, Filipino after having

been duly sworn to an oath in accordance with law do hereby
depose and say:

2. That I am a holder of St. Gregory – St. Peter Life Plan under policy
no. L(180840) 1608068A.
3. When asked to present my copy of the Plan in order to avail of
certain benefits, I realized that I had inadvertently misplaced my
copy;
4. Despite a diligent and exhaustive search for my copy of the Plan,
I was unable to locate it, and must assume that it is now lost and
irretrievable;
5. I am executing this Affidavit to attest to the truth of the foregoing
facts, to support my application for a new copy of the Plan to
be issued, and for whatever other official and lawful purposes it
may serve.

of September, 2017 at Cauayan City, Isabela.
MILLIE JOY MORENO
ROMAN
Affiant
SUBSCRIBED AND SWORN to before me this 25th day of September,

2017 at Roxas, Isabela.
Doc. No. ________

Page No. ________
Book No. ________
Series of 2017

Affidavit of Loss CR 2

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Republic of the Philippines )

PROVINCE OF ISABELA ) s.s.

I, JAYSON BALAO ABORDO, of legal age, Filipino and a resident

1. That I am the same person executing this affidavit;

2. That I and Sheena Mae Garcia Abordo (Sheena for brevity)

3. That during our marriage together as husband and wife we

IN WITNESS WHEREOF, I have hereunto set my hand this 25nd day

SUBSCRIBED AND SWORN to before me this 25th day of October,

Doc. No. ________

Republic of the Philippines )

I, MARLON A. VILLANUEVA, of legal age, Filipino and a resident

1. That I am the same person executing this affidavit;

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day

SUBSCRIBED AND SWORN to before me this 17th day of October,

Doc. No. ________

I, EMMANUEL SINGSON ANTALAN, of legal age, Filipino and a

1. That I am the same person executing this affidavit;

IN WITNESS WHEREOF, I have hereunto set my hand this 20th day

EMMANUEL SINGSON ANTALAN

Doc. No. ________

Republic of the Philippines )

I, MILLIE JOY MORENO ROMAN, of legal age, Filipino after having

1. That I am the same person executing this affidavit;

IN WITNESS WHEREOF, I have hereunto set my hand this 25th day

SUBSCRIBED AND SWORN to before me this 25th day of September,

Doc. No. ________

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