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Affidavit of Loss: in Witness Whereof

The document is an affidavit of loss filed by an individual who lost their identification card. It states that the individual was a bonafide holder of an ID card issued in [location] but noticed it was missing when they went to use it. Despite searching everywhere, the ID could not be found. The affidavit asserts that the lost ID should now be considered lost and the individual is filing it to attest to the truth of the loss and request a new replacement ID.

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200 views1 page

Affidavit of Loss: in Witness Whereof

The document is an affidavit of loss filed by an individual who lost their identification card. It states that the individual was a bonafide holder of an ID card issued in [location] but noticed it was missing when they went to use it. Despite searching everywhere, the ID could not be found. The affidavit asserts that the lost ID should now be considered lost and the individual is filing it to attest to the truth of the loss and request a new replacement ID.

Uploaded by

ferj
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 )

___________________ ) S.S.

AFFIDAVIT OF LOSS

I, ____________________________, of legal age, Filipino, with residence


address at __________________________________, after being duly sworn in
accordance with law, hereby state:

1. I am a bonafide holder of __________________________ bearing the


No. ________________________ issued at
________________________;

2. That sometime in _______________ when I was about to use the


said ID, I noticed that my _____________________ was missing. I
searched all the possible place where I might have placed the same
but the same proved to be futile;

3. Since the ID could not be found, for all intents and purposes, my
__________________ with number ____________________ issued at
_____________________ should now be considered lost;

4. I am executing this affidavit to attest to the truth of the foregoing


and to secure a new ______________________ ID in replacement of
the lost one.

IN WITNESS WHEREOF, I have hereunto set my hand this ______day of


_________ 2015 in __________________.

_______________________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of _____ 2015 in


_______________, affiant exhibiting to me his/her
_______________________________.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2015.

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