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    Affidavit of Loss of PRC Card

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    EmyFalco
    Illuminada Gomez-Lopez, a certified civil engineer, lost her identification card issued by the Professional Regulation Commission on June 30, 2019. She has made efforts to locate the card but was unable to find it. The card was not confiscated by any law enforcement and was not offered as collateral for a loan. She is submitting this affidavit of loss to support her application for a new identification card to replace the lost one.

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    Affidavit of Loss of PRC Card

    Uploaded by

    EmyFalco
    161 views1 page
    Illuminada Gomez-Lopez, a certified civil engineer, lost her identification card issued by the Professional Regulation Commission on June 30, 2019. She has made efforts to locate the card but was unable to find it. The card was not confiscated by any law enforcement and was not offered as collateral for a loan. She is submitting this affidavit of loss to support her application for a new identification card to replace the lost one.

    Original Description:

    Replacement of a Lost Professional REgualtion Commission Card

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    Illuminada Gomez-Lopez, a certified civil engineer, lost her identification card issued by the Professional Regulation Commission on June 30, 2019. She has made efforts to locate the card but was unable to find it. The card was not confiscated by any law enforcement and was not offered as collateral for a loan. She is submitting this affidavit of loss to support her application for a new identification card to replace the lost one.

    Copyright:

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

    Affidavit of Loss of PRC Card

    Uploaded by

    EmyFalco
    Illuminada Gomez-Lopez, a certified civil engineer, lost her identification card issued by the Professional Regulation Commission on June 30, 2019. She has made efforts to locate the card but was unable to find it. The card was not confiscated by any law enforcement and was not offered as collateral for a loan. She is submitting this affidavit of loss to support her application for a new identification card to replace the lost one.

    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)

    Quezon City, Metro Manila . . . . . . ) S.S.

    AFFIDAVIT OF LOSS

    I, ILLUMINADA GOMEZ-LOPEZ, of legal age, Filipino citizen, married, and a


    resident of #49 Lopez Jaena Street, Barangay Doña Aurora, Galas, Quezon City, Metro
    Manila, Republic of the Philippines, after having duly sworn to in accordance with the
    law, hereby depose and say that:

    1. I am a holder of a Certified Civil Engineer Identification Card with Registration No.


    0020495 issued by Professional Regulation Commission;

    2. I lost said Identification card on June 30, 2019, and that I exerted all my efforts to
    locate the same but I could not remember exactly where I placed it and it is considered
    lost for all legal purposes;

    3. Said Identification card was not confiscated by any officer of the law by reason of
    any violation of any law, ordinance, presidential decree or rules and regulation of the
    said Commission; and neither was it offered as collateral for any loan;

    4. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
    and to support my application for the issuance of a new Certified Civil Engineer
    Identification Card, in lieu of the one that was lost.

    IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at


    _____________, Republic of the Philippines.

    ILLUMINADA GOMEZ-LOPEZ
    Affiant

    SUBSCRIBED AND SWORD to before me this ____________________ in


    _______________, Republic of the Philippines. Affiant personally came and appeared
    with her Office of the Senior Citizens Affairs (OSCA) with I.D. No. 11508-5 issued by the
    OSCA of Quezon City, Metro Manila, bearing her photograph and signature, known to
    me as the same person who personally signed the foregoing instrument before me and
    avowed under penalty of law to the whole truth of the contents of said instrument.

    Notary Public

    Doc. No. _____;


    Page No. _____;
    Book No. _____;
    Series of 2019.

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