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    Affidavit of Loss

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    Cali Gale
    Angelica Marie Tubo Valdez executed an Affidavit of Loss to report that on January 4, 2020, she realized her wallet containing her government ID, driver's license, ATM cards, and Philippine National ID was missing after riding a jeep home. She believes it may have accidentally fallen out of her pants. Despite efforts to locate her bag or identify a culprit, she was unable to find it. She is executing the affidavit to request re-issuance of the missing identification cards and to attest to the truth of the reported loss. The affidavit was signed and sworn to before a notary public on January 10, 2020 in San Fernando, Pampanga.

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    Affidavit of Loss

    Uploaded by

    Cali Gale
    18 views4 pages
    Angelica Marie Tubo Valdez executed an Affidavit of Loss to report that on January 4, 2020, she realized her wallet containing her government ID, driver's license, ATM cards, and Philippine National ID was missing after riding a jeep home. She believes it may have accidentally fallen out of her pants. Despite efforts to locate her bag or identify a culprit, she was unable to find it. She is executing the affidavit to request re-issuance of the missing identification cards and to attest to the truth of the reported loss. The affidavit was signed and sworn to before a notary public on January 10, 2020 in San Fernando, Pampanga.

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    Original Title

    Affidavit-of-Loss

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    Angelica Marie Tubo Valdez executed an Affidavit of Loss to report that on January 4, 2020, she realized her wallet containing her government ID, driver's license, ATM cards, and Philippine National ID was missing after riding a jeep home. She believes it may have accidentally fallen out of her pants. Despite efforts to locate her bag or identify a culprit, she was unable to find it. She is executing the affidavit to request re-issuance of the missing identification cards and to attest to the truth of the reported loss. The affidavit was signed and sworn to before a notary public on January 10, 2020 in San Fernando, Pampanga.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    18 views4 pages

    Affidavit of Loss

    Uploaded by

    Cali Gale
    Angelica Marie Tubo Valdez executed an Affidavit of Loss to report that on January 4, 2020, she realized her wallet containing her government ID, driver's license, ATM cards, and Philippine National ID was missing after riding a jeep home. She believes it may have accidentally fallen out of her pants. Despite efforts to locate her bag or identify a culprit, she was unable to find it. She is executing the affidavit to request re-issuance of the missing identification cards and to attest to the truth of the reported loss. The affidavit was signed and sworn to before a notary public on January 10, 2020 in San Fernando, Pampanga.

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    © All Rights Reserved
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    REPUBLIC OF THE PHILIPPINES)

    City of Sanfernando, Pampanga) SS.

    Affidavit of Loss

    I, Angelica Marie Tubo Valdez, 20 of legal age and residing/with address at Fortune Ville 1,

    Baliti Pampanga, under oath, state:

    1. That on January 4, 2020 around 4 in the afternoon. I was surprised to have known that my

    wallet was already missing as it might have accidentally fell-off from my pants when I was

    riding a jeep on my way home.

    2. THAT my wallet where I put Government ID, Driver’s License, ATM Cards, Philippine

    National ID and some money bills were missing.

    3. I exerted diligence efforts to locate my Bag or to identify the culprit but to no avail and I

    therefore considered the same as lost and cannot be found.

    4. THAT I have to request for the re-issuance of these new IDENTIFICATION CARDS

    (Driver’s License ATM Cards and Philippine National ID) in furtherance of my personal

    transaction and such other business transaction which may require the presentation of those

    aforementioned missing ID’s

    5. THAT I am executing this Affidavit to attest to the truth of the foregoing facts and to use the

    same for whatever legal purpose it may serve.

    IN WITNESS WHEREOF, I hereunto affix my signature this 10th day of January, 2020 at

    Sanfernando, Pampanga

    Alrdin Caparas

    Affiant
    SUBSCRIBED & SWORN to before me in the City of San Fernando, Pampanga, this

    10th day of January 2020, by ANGELICA MARIE T. VALDEZ, who has satisfactorily proven

    to me her identity through her COMELEC ID No. ABC 09874-846238-ALSJDOWJSDK1-8,

    issued by the COMELEC that she is the same person who personally signed before me the

    foregoing affidavit and acknowledge that she executed the same.

    Doc. No 084 Notary Public

    Page No. 45

    Book No. XLI

    Series of 2020
    Parts of the Affidavit of Loss:
    An Affidavit of Loss contains the following essential parts:

    1. Title of the document


    2. Your name, statement that you are of legal age, civil status, citizenship, and
    residence address.
    3. A narration of the circumstances of the loss, which includes (i) description of
    the item or document lost; (ii) description of how it got lost; (iii) the effort
    exerted to find it; and (iv) your request for a replacement of the item or
    document lost.
    4. The signature of the affiant. Affiant is the person executing/signing the
    document.
    5. The jurat. The jurat is the oath or affirmation before the notary public that you
    have personally executed the document in the presence of the notary.

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