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    Sample Affidavit of Loss

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    Nash Dee
    Baican Benito Marohomsalic executed an affidavit of loss stating that on November 15, 2019 while traveling from Brgy. Salam, MSU, Marawi City to Cotabato City, he misplaced a pouch containing his savings and dollar account passbooks from the Philippine National Bank issued under his name. Despite exerting diligent efforts, he was unable to locate the lost pouch. He executed this affidavit to attest to the truth of these facts and to request the reissuance of a new passbook.

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    Sample Affidavit of Loss

    Uploaded by

    Nash Dee
    70 views1 page
    Baican Benito Marohomsalic executed an affidavit of loss stating that on November 15, 2019 while traveling from Brgy. Salam, MSU, Marawi City to Cotabato City, he misplaced a pouch containing his savings and dollar account passbooks from the Philippine National Bank issued under his name. Despite exerting diligent efforts, he was unable to locate the lost pouch. He executed this affidavit to attest to the truth of these facts and to request the reissuance of a new passbook.

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    sample affidavit of loss

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    Baican Benito Marohomsalic executed an affidavit of loss stating that on November 15, 2019 while traveling from Brgy. Salam, MSU, Marawi City to Cotabato City, he misplaced a pouch containing his savings and dollar account passbooks from the Philippine National Bank issued under his name. Despite exerting diligent efforts, he was unable to locate the lost pouch. He executed this affidavit to attest to the truth of these facts and to request the reissuance of a new passbook.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    70 views1 page

    Sample Affidavit of Loss

    Uploaded by

    Nash Dee
    Baican Benito Marohomsalic executed an affidavit of loss stating that on November 15, 2019 while traveling from Brgy. Salam, MSU, Marawi City to Cotabato City, he misplaced a pouch containing his savings and dollar account passbooks from the Philippine National Bank issued under his name. Despite exerting diligent efforts, he was unable to locate the lost pouch. He executed this affidavit to attest to the truth of these facts and to request the reissuance of a new passbook.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    REPUBLIC OF THE PHILIPPINES )

    City of Cotabato )
    X-----------------------------------X

    AFFIDAVIT OF LOSS

    I, BAICAN BENITO MAROHOMSALIC, of legal age and residing at


    Rosary Heights X, Cotabato City, Maguindanao, under oath, state:

    1. THAT on November 15, 2019, I travelled from Brgy. Salam, MSU,


    Marawi City to Cotabato City when I misplaced my pouch containing
    among others my Passbook (Savings Account and Dollar Account)
    from Philippine National Bank;

    2. THAT said passbooks where issued by PNB under my name;

    3. THAT the said pouch containing my passbooks were lost without


    my knowledge;

    4. THAT I exerted diligent efforts to locate the said pouch but to no


    avail and I therefore considered the same as lost and can no longer
    be found;

    5. THAT I am executing this Affidavit to attest to the truth of the


    foregoing facts and to use the same for my request for a reissuance
    of a new passbook and for whatever legal purpose it may serve.

    IN WITNESS WHEREOF, I hereunto affix my signature this December 4, 2019


    at Cotabato City, Philippines.

    BAICAN BENITO MAROHOMSALIC


    Affiant

    SUBSCRIBED AND SWORN to before me this December 4, 2019 at


    Cotabato City, Philippines. Affiant exhibited to me his/her Valid Identification
    Card with picture and signature thereof.

    Doc. No. _______


    Page No._______
    Book No. ______
    Series of 2019

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