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    Gamayon-Affidavit of Loss

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    reese93

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    Gamayon-Affidavit of Loss

    Uploaded by

    reese93
    17 views1 page

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    Copyright:

    © All Rights Reserved
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    Download as pdf or txt
    17 views1 page

    Gamayon-Affidavit of Loss

    Uploaded by

    reese93

    Copyright:

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

    Republic of the Philippines )

    ____________,_____________ ) S.S.

    AFFIDAVIT OF LOSS

    KNOW ALL MEN BY THESE PRESENTS:

    I, __________________________ of legal age, Filipino, single/married, and a resident of


    ________________________________________________ , after having been sworn in
    accordance with law, hereby deposes and states the following:

    1. I am holder/owner/ or possessor of the following identification card / document:


    _____________________________

    2. I have recently discovered the said item/s is/are irretrievably lost and can no
    longer be found despite diligent efforts to locate the same;

    3. I execute this affidavit to attest to the truth of the foregoing.

    Signed on the date and at the place indicated below.

    Affiant
    (Signature over Printed Name)
    Competent Evidence of Identity
    ID:
    issued on:
    at:

    SUBSCRIBED and SWORN TO before me on the date and at the place indicated below. The
    affiant exhibited to me his competent evidence of identity as indicated above.

    Signed this ______________at ________________, ______________________, Philippines.

    WITNESS MY HAND AND SEAL.

    Notary Public

    Doc. No.
    Page No.
    Book No. I
    Series of

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