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Affidavit of Loss: IN WITNESS WHEREOF, I Have Hereunto Affixed My Signature This

This document contains 3 affidavits of loss sworn by different individuals before a notary public in Nueva Ecija, Philippines. The first affidavit details the loss of an official receipt for a bail bond. The second affidavit describes the loss of books of account and official receipts for a gift shop. The third affidavit concerns the loss of books of account, official receipts, and a certificate of registration for a bakery. In each case, the affiant kept the documents in question but later discovered they were missing, despite searching, and executed the affidavits to inform the relevant authorities of the losses.

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Sahlee Guillermo
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85 views5 pages

Affidavit of Loss: IN WITNESS WHEREOF, I Have Hereunto Affixed My Signature This

This document contains 3 affidavits of loss sworn by different individuals before a notary public in Nueva Ecija, Philippines. The first affidavit details the loss of an official receipt for a bail bond. The second affidavit describes the loss of books of account and official receipts for a gift shop. The third affidavit concerns the loss of books of account, official receipts, and a certificate of registration for a bakery. In each case, the affiant kept the documents in question but later discovered they were missing, despite searching, and executed the affidavits to inform the relevant authorities of the losses.

Uploaded by

Sahlee Guillermo
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 Nueva Ecija ) S.S.


Science City of Muñoz )

AFFIDAVIT OF LOSS

I, DOMICIANO FELIPE R. LAURENA, IV, of legal age, Filipino,


widower, presently residing at Unit 203 2nd Floor Pulido Building, d delos Santos
Street, Science City of Muñoz, Nueva Ecija, under oath, state:

1. I am the payor of the bailbond of Romano Conosa in the Criminal


Case No. 13-46315-C in the amount of Sixteen Thousand Pesos
( 16,000 ) under Official Receipt No. 7174049 dated September 4,
2014 issued to me by Office of the Clerk of Court Antipolo City;

2. I kept the said Official Receipt in one of the cabinets in my room


together with other documents but to my surprise I discovered
sometime on June 2019 that Official Receipt was missing;

3. I took pains in looking for the said Official Receipt but to no avail
and the same cannot be found anymore;

4. I have executed this affidavit to affirm and attest to the fact that the
said receipt was lost and by virtue of this affidavit I would like to
inform the Office of the Clerk of Court office about the facts of its
lost.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


________________ at Science City of Muñoz, Nueva Ecija.

DOMICIANO FELIPE R. LAURENA, IV


Affiant

SUBSBRIBED and SWORN to before me this ___________________ at


Science City of Muñoz, Nueva Ecija and I hereby certify that the affiant has read
the contents of her affidavit and understands the same.

Doc. No. ___;


Page No. ___;
Book No. ___;
Series of 2020.
REPUBLIC OF THE PHILIPPINES )
Province of Nueva Ecija ) S.S.
Science City of Muñoz )

AFFIDAVIT OF LOSS

I, MARIE GRACE P. ELAURIA, of legal age, Filipino, married, presently


residing at Purok 4, Barangay Baloc, Sto. Domingo, Nueva Ecija, under oath, state:

5. That, I am the owner of GRACE GIFT SHOP & SARI-SARI


STORE at Purok 4, Barangay Baloc, Sto. Domingo, Nueva Ecija
with Certificate of Registration No. _____ issued to me by Bureau
of Internal Revenue office registered at Bureau of Internal
Revenue office;

6. That, Bureau of Internal Revenue office issued me Books of


Account and Official Receipts.

7. That I kept the said Books of Account and Official Receipts in one
of the cabinets in my shop together with other documents but to my
surprise I discovered sometime on May 2009 that the said Books of
Account and Official Receipts was missing;

8. That, I took pains in looking for the said Books of Account and
Official Receipts but to no avail and the same cannot be found
anymore;

9. That, I have executed this affidavit to affirm and attest to the fact
that the said certificate was lost and by virtue of this affidavit I
would like to inform the Bureau of Internal Revenue office about
the facts of its lost.

IN WITNESS WHEREOF, I have hereunto affixed my signature this April


25, 2019 at Science City of Muñoz, Nueva Ecija.

MARIE GRACE P. ELAURIA


Affiant
CRN: 0111-6915399-4

SUBSBRIBED and SWORN to before me this April 25, 2019 at Science City
of Muñoz, Nueva Ecija and I hereby certify that the affiant has read the contents of
her affidavit and understands the same.
Doc. No. 144;
Page No. 30;
Book No. VI;
Series of 2019.

REPUBLIC OF THE PHILIPPINES )


Province of Nueva Ecija ) S.S.
Science City of Muñoz )

AFFIDAVIT OF LOSS

I, CRISELDA S. LUMACTUD, of legal age, Filipino, married, presently


residing at Science City of Muñoz, Nueva Ecija, under oath, state:

10. That, I am the owner of CSL Bakery at Science City of Muñoz


Market with Certificate of Registration No. 2313 issued to me by
Bureau of Internal Revenue office;

11. That, Bureau of Internal Revenue office issued me Books of


Account and Official Receipts.

12. That I kept the said Books of Account and Official Receipts in one
of the cabinets in my shop together with other documents but to my
surprise I discovered sometime on May 2006 that the said Books of
Account and Official Receipts was missing;

13. That, I took pains in looking for the said Books of Account and
Official Receipts but to no avail and the same cannot be found
anymore;

14. That, I have executed this affidavit to affirm and attest to the fact
that the said certificate was lost and by virtue of this affidavit I
would like to inform the Bureau of Internal Revenue office about
the facts of its lost.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


February 27, 2019 at Science City of Muñoz, Nueva Ecija.

CRISELDA S. LUMACTUD
Affiant

SUBSBRIBED and SWORN to before me this February 27, 2019 at Science


City of Muñoz, Nueva Ecija and I hereby certify that the affiant has read the
contents of her affidavit and understands the same.
Doc. No. ___;
Page No. ___;
Book No. II;
Series of 2016.

REPUBLIC OF THE PHILIPPINES )


Province of Nueva Ecija ) S.S.
Science City of Muñoz )

AFFIDAVIT OF LOSS

I, CRISELDA S. LUMACTUD, of legal age, Filipino, married, presently


residing at Science City of Muñoz, Nueva Ecija, under oath, state:

15. That, I am the owner of CSL Bakery at Science City of Muñoz


Market with Certificate of Registration No. 2313 issued to me by
Bureau of Internal Revenue office;

16. That, I kept the said Certificate in one of the cabinets in my shop
together with other documents but to my surprise I discovered
sometime on May 2008 that the said Certificate was missing;

17. That, I took pains in looking for the said Certificate but to no avail
and the same cannot be found anymore;

18. That, I have executed this affidavit to affirm and attest to the fact
that the said certificate was lost and by virtue of this affidavit I
hereby request the Bureau of Internal Revenue office to issue
another in lieu of the one which was lost.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


September 1, 2016 at Science City of Muñoz, Nueva Ecija.

CRISELDA S. LUMACTUD
Affiant

SUBSBRIBED and SWORN to before me this September 1, 2016 at Science


City of Muñoz, Nueva Ecija and I hereby certify that the affiant has read the
contents of her affidavit and understands the same.

Doc. No. ___;


Page No. ___;
Book No. II;
Series of 2016.

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