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Affidavit of Loss Blank Form

Affidavit of Loss, blank with a reason of being misplaced.

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Ella Marie Sanico-Abustan
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37 views

Affidavit of Loss Blank Form

Affidavit of Loss, blank with a reason of being misplaced.

Uploaded by

Ella Marie Sanico-Abustan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LAGUNA
)S.S.
CITY OF CALAMBA
)

AFFIDAVIT OF LOSS
I,

_________________________, of legal age Filipino citizen, and


with
residence
and
postal
address
at
__________________________________________________________________
after having been duly sworn to in accordance with law, hereby
depose and state:
1. That
I
am
the
holder
of
a
certain
_______________________________________________ issued to me
by ____________________________________.
2. That
the
said
_______________________________________________________________
______ was/were lost and/or misplaced and in our house and
notwithstanding
diligent
effort
to
locate
the
said
________________________________________________ but to no
avail, and the same can no longer be found.
That I am executing this statement to attest to the truthfulness
of the foregoing, and for whatever legal purpose it may serve.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
____________________________, at Calamba City, Laguna. Philippines.

________________________________
Affiant
SUBSCRIBED
AND
SWORN
TO
BEFORE
________________________________ at Calamba City, Laguna.

ME

NOTARY PUBLIC
Doc. No.
Page No.
Book No.
Series of

this

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