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A FFIDAVIT

The affidavit details the loss of official registration documents for a vehicle owned by the affiant. It provides identifying details of the vehicle, states that the official receipt and certificate of registration were misplaced and could not be found despite efforts to locate them. The affiant asserts that the documents were not transferred, encumbered, or confiscated. The purpose of the affidavit is to support a request for duplicate registration documents from the Land Transportation Office and establish the veracity of the statements made.

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Ervien A. Mendoza
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153 views1 page

A FFIDAVIT

The affidavit details the loss of official registration documents for a vehicle owned by the affiant. It provides identifying details of the vehicle, states that the official receipt and certificate of registration were misplaced and could not be found despite efforts to locate them. The affiant asserts that the documents were not transferred, encumbered, or confiscated. The purpose of the affidavit is to support a request for duplicate registration documents from the Land Transportation Office and establish the veracity of the statements made.

Uploaded by

Ervien A. Mendoza
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 )

CITY OF GENERAL SANTOS ) S.S.


X---------------------------------------X

AFFIDAVIT OF LOSS

I, _______________________, of legal age, Filipino Citizen, single, with residence and postal
address at ______________________, after having been duly sworn to in accordance with law, hereby
depose and say THAT:

1. I am the registered owner of a Motor Vehicle which is more properly described as follows:

MAKE/SERIES : ISUZU
TYPE OF BODY : TRUCK DROPSIDE
PLATE NO. :
MOTOR NO. :
SERIAL CHASSIS NO. :
OFFICIAL RECEIPT NO. : -
CERT. OF REG. NO. : -
MV FILE NO. :

2. As proof of ownership of the above-described vehicle I was issued by the Land


Transportation Office, Official Receipt (OR) and Certificate of Registration (CR);

3. That current status of the said vehicle’s registration is STORED;

3. The OR and CR of the said vehicle while in my possession were misplaced/lost and could no
longer be found in spite of diligent efforts to locate them;

4. Said documents were neither transferred to other persons/entity/financial institutions for any
consideration nor encumbered to guarantee financial obligations with any financial
institution;

5. Said documents were not confiscated by any government authorities for violation of R.A.
4136 or otherwise known as the Land Transportation and Traffic Code and other related laws;
and

6. I shall assume responsibility or liability if in any event I will use these documents for
whatever illicit transactions; and

7. I am executing this affidavit to attest to the veracity of my statements and to support my


request for the reactivation of the said vehicle’s registration and for the duplicate copies of
the lost OR and CR with the Land Transportation Office (LTO), GSC and for whatever legal
purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________________ at


General Santos City, Philippines.

--------------------------------
Affiant
____________________________

SUBSCRIBED AND SWORN to before me this ______________ at General Santos City,


Philippines. Affiant has shown to me his valid ID as written below his name.

Doc. No. ____;


Page No. ____;
Book No. ____ ;
Series of 2018.

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