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    Affidavit of Loss

    Uploaded by

    Rhiza Malones
    This affidavit of loss documents that an individual lost their original life insurance policy from St. Peter Life Plan in Iloilo City, Philippines. The affiant discovered in January 2020 that the original policy from June 2019 was lost among files in their home despite searching. They are filing this affidavit to attest to the truth of the loss and to request a replacement policy. The affiant signed on September 8, 2020 in Iloilo City to document the loss.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Affidavit of Loss

    Uploaded by

    Rhiza Malones
    39 views1 page
    This affidavit of loss documents that an individual lost their original life insurance policy from St. Peter Life Plan in Iloilo City, Philippines. The affiant discovered in January 2020 that the original policy from June 2019 was lost among files in their home despite searching. They are filing this affidavit to attest to the truth of the loss and to request a replacement policy. The affiant signed on September 8, 2020 in Iloilo City to document the loss.

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    affidavit-of-loss

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    This affidavit of loss documents that an individual lost their original life insurance policy from St. Peter Life Plan in Iloilo City, Philippines. The affiant discovered in January 2020 that the original policy from June 2019 was lost among files in their home despite searching. They are filing this affidavit to attest to the truth of the loss and to request a replacement policy. The affiant signed on September 8, 2020 in Iloilo City to document the loss.

    Copyright:

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

    Affidavit of Loss

    Uploaded by

    Rhiza Malones
    This affidavit of loss documents that an individual lost their original life insurance policy from St. Peter Life Plan in Iloilo City, Philippines. The affiant discovered in January 2020 that the original policy from June 2019 was lost among files in their home despite searching. They are filing this affidavit to attest to the truth of the loss and to request a replacement policy. The affiant signed on September 8, 2020 in Iloilo City to document the loss.

    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)

    Iloilo City )S.S


    x------------------------------x

    AFFIDAVIT OF LOSS

    I, ____________________, of legal age, married, Filipino citizen and


    a resident of _________________________, Philippines, under oath, depose and
    say that:

    That I am a bona fide plan holder of St. Peter Life Plan, Iloilo City with
    _____________________ with effectivity date June 19, 2019;

    That sometime in January 2020, I discovered said Original LPA Policy was
    lost or misplaced among my voluminous file at my house and despite diligent
    efforts to locate the same could not be found and believed lost already;

    I am executing this Affidavit of Loss to attest to the truth of the foregoing


    and in support of my request/application for the replacement of the said St.
    Peter Life Plan Policy.

    IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of


    September 2020 at Iloilo City, Philippines.

    _______________________
    Affiant

    SUBSCRIBED AND SWORN to before me this 8th day of September


    2020 at Iloilo City, Philippines, affiant exhibiting to me his ____________ as his
    competent evidence of identity.

    Doc. No. _____;


    Page No. _____;
    Book No. _____;
    Series of 2020

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