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Affidavit of Loss LTO VFS 488

Rinabeth L. Arellano files an affidavit of loss for the official receipt and certificate of registration documents for her Mitsubishi SUV. She states that the documents were misplaced despite her efforts to locate them, and were not in the possession of any banks, companies, or government authorities. She assumes responsibility for any liability if the documents are used for illegal purposes or third party claims. She executes the affidavit to support her request for duplicate documents from the Land Transportation Office.

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claire.anuba28
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18 views1 page

Affidavit of Loss LTO VFS 488

Rinabeth L. Arellano files an affidavit of loss for the official receipt and certificate of registration documents for her Mitsubishi SUV. She states that the documents were misplaced despite her efforts to locate them, and were not in the possession of any banks, companies, or government authorities. She assumes responsibility for any liability if the documents are used for illegal purposes or third party claims. She executes the affidavit to support her request for duplicate documents from the Land Transportation Office.

Uploaded by

claire.anuba28
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 DAVAO

x------------------------------------------x

AFFIDAVIT OF LOSS OR

I, Rinabeth L. Arellano of legal age, married, Filipino and resident of Lot 3586-1 Purok San
Andres< Barangay Indangan, Davao City, after having been sworn to in accordance with law, hereby
depose and state:

1. That I am the registered owner of the motorcycle described below as to wit:

Make & Type :Mitsubishi SUV


Motor Number :4D56UCEF3149
Chasis Number :MMBGNKG40DD008707
Plate Number VFS 488

2. That, as proof of ownership of the above described motorcycle I was issued by the Land
Transportation Office, Official Receipt (OR) as proof of payment and Certificate of Registration
(CR);

3. That the said documents while in my possession were misplaced and could no longer be located
inspite of exerting efforts of locating them;

4. That the said documents were not in the possession of any bank institutions or lending companies
by reason of encumbrance or chattel mortgage of the subject vehicle;

5. That the said documents were not confiscated by any government authorities in violation of R.A.
4136 and other related laws;

6. That I shall assume any responsibilities or liability if any event I will use these documents for
whatever elicit transactions;

7. That I am executing this affidavit to attest to the veracity of my statement and to support the same
in its request for duplicate copies of the lost OR/CR at the Land Transportation Office (LTO)
where is has a hand over subject;

8. That I bind myself criminally civilly and administratively liable and will assume full
responsibility for any 3rd party claim, and I hereby hold the Land Transportation Office or any of
its employees free from any liability arising from any claim for damages as a result of the
registration of the vehicle and or issuance of replacement certificate of registration.

9. IN WITNESS HEREOF, I hereunto affix my signature this ______________________ in Davao


City

Rinabeth L. Arellano
Affiant
CRN – 0009-2034937-5

SUBSCRIBED AND SWORN TO before me this ____day of ________2021 at Davao City


Philippines. Affiant exhibiting to me his valid identification as stated above

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