Affidavit of Loss: Republic of The Philippines) City and Province of Iloilo) S.S
Affidavit of Loss: Republic of The Philippines) City and Province of Iloilo) S.S
AFFIDAVIT OF LOSS
2. That the corporation is the registered owner of the utility vehicle described below, as to
wit:
Model: 2018
3. That, as proof of ownership of the above described vehicle I was issued by the Land
Transportation Office (LTO) the Official Receipt (OR) as proof of payment and
Certificate of Registration (CR);
4. That the LTO also released the official plate with plate number;
5. That the plate was in my possession and was already installed but because of force
majeure it was misplaced and can no longer be found despite of exerting efforts of
locating it;
6. That the said plate was not confiscated by any government authorities for any violation;
7. That I am executing this affidavit to attest to the veracity of my statement and support the
same in its request for duplicate copy of the lost copy; and
8. I bind myself criminally, civilly, and administratively liable and will assure responsibility
for any third party claim, and hereby hold any other government agency free from any
liability arising from any claim for damages as a result of issuance of replacement of the
above mentioned document.
IN WITNESS WHEREOF, I have hereunto set my hands this 27th day of October, 2020, in
Iloilo, Philippines.
EMMANUEL P. RAMOS
Affiant
Page1
SUBSCRIBED AND SWORN to before me this 27th day of October, 2020, in Iloilo,
Philippines. Affiant exhibited to me his ID ________________________, bearing the affiants
photograph and signature, thru which his identity was confirmed.
Page1