Affidavit of Loss: Republic of The Philippines) City of Muntinlupa) S.S
Affidavit of Loss: Republic of The Philippines) City of Muntinlupa) S.S
AFFIDAVIT OF LOSS
I, WARREN, of legal age, single, Filipino and a resident of Sitio Ludlod, Brgy.
Ambulong, Tanauan City, Batangas after having been sworn to in accordance with law
depose and state;
That I am the fleet coordinator of located at Purok 2, A. Mabini highway, Barangay
Talaga, Tanauan City;
That I am the custodian and in possession of the plate no. ABX1160 from a 2016
Toyota Vios vehicle owned by the company;
That sometime in September 2022, I parked the above-stated vehicle in the South
Super Highway, Brgy. Alabang, on the streets of Muntinlupa along Starmall, Metro
Manila, to buy vehicle parts for repair, but when I come back, I noticed that the attached
plate was already missing
That despite my diligent efforts to locate said plate within the vicinity of the
incident, the same could no longer be found and was now beyond recovery;
That I am executing this affidavit to attest to the veracity of the foregoing facts and
for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this _____day of ____ 2022
at Muntinlupa City, Metro Manila.
Affiant
SUBSCRIBED AND SWORN TO before me this _____day of _______ 2022 at
Muntinlupa City, Metro Manila. Affiant exhibiting to me his Philhealth noas proof of
his identity.
Doc. No._____
Page No._____
Book No._____
Series of 2022