Affidavit of Loss Maria Mihcoel Ona Yeji

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AFFIDAVIT OF LOSS

 
 
REPUBLIC OF THE PHILIPPINES)
QUEZON CITY ) S.S. 
                                                     
 
I, Maria Mihcoel Ona, Filipino, of legal age, residing at Manila River City
Residences, Pedro Gil St. Sta Ana, Manila, Metro Manila, after having been
sworn in accordance with law hereby depose and state:
 
That I am the true and lawful owner of a Bank of the
Philippine Islands (BPI) ATM card, more particularly described as
follows:
 
CARD NAME: BANK OF THE PHILIPPINE ISLANDS SAVINGS
ACCOUNT ATM CARD

Estimated Date of loss: February 2021


         
That sometime on February 2021, my Bank of the Philippine
Islands (BPI) ATM card was lost, after spending time looking for it,
said BPI ATM card could not be found;
 
          That I exerted best efforts to look for said Bank of the
Philippine Islands (BPI) ATM card but to no avail;
 
          That I am executing this affidavit to attest to the truth of the
foregoing and to request from Bank of the Philippine Islands Santa
Ana branch, to invalidate/cancel/revoke the BPI ATM card that was
lost and to issue a replacement of the same.
 
IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of
_______________. 20___ at _________________________.
 
                  
                   
                                                                      
Maria Mihcoel Ona
         Affiant
 
         
SUBSCRIBED AND SWORN to before me, this ____ day of
______________, 20___ in ___________________ City, with affiant exhibiting
his/her _______________________________,
Issued on ________________________ at _______________________,
Philippines.
 
 
 

Doc.  No. :  ________;


Page  No. :  ________;
Book No. :  ________;
Series of 20_______.

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