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Affidavit of Loss of Passport

This affidavit details the loss of a Filipino passport. It states the passport number and date and place of issue. It then explains the circumstances surrounding the loss and has the affiant sign to attest that the information provided is true. It is notarized by a consular officer.

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Gladys Serrano
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99 views1 page

Affidavit of Loss of Passport

This affidavit details the loss of a Filipino passport. It states the passport number and date and place of issue. It then explains the circumstances surrounding the loss and has the affiant sign to attest that the information provided is true. It is notarized by a consular officer.

Uploaded by

Gladys Serrano
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AFFIDAVIT OF LOSS OF PASSPORT

I,_______________________________ , Filipino citizen, of legal age and presently residing at


___________________________________________________________________________________
after having been duly sworn to in accordance with law, hereby depose and state:

1. That I am a holder of Philippine Passport No. _____________________ issued on


____________________ at ____________________________;

2. That the circumstances surrounding the loss of my passport are as follows:

__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
________________________________________________________________________.

3. That I execute this affidavit for the purpose of giving true and correct statement surrounding
the loss of my passport.

IN WITNESS WHEREOF, I have hereunto signed my name below this day of


_________________ at __________________________.

___________________________
Affiant
(Full Name and Signature)

SUBSRIBED AND SWORN to before me this day of ________________________, at


__________________________, affiant exhibiting to me his/her valid proof of identification.

Doc. No. : ________


Service No.: ________
Book No. : ________
Series of : ________ __________________________
Fee Paid : ________ Consular Officer
O.R. No. : ________

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