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01 Affidavit of Loss

The document is an affidavit of loss form that has been filled out. It details that the owner lost an unspecified item sometime last year and has made efforts to find it but was unable to recover it. It states the item was not confiscated by the government and the affidavit is being made to attest to the truth of the information.

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0% found this document useful (0 votes)

24 views1 page

01 Affidavit of Loss

Uploaded by

Nas Sampaco

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as DOCX, PDF, TXT or read online on Scribd

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REPUBLIC OF THE PHILIPPINES )

Municipality / City of _______________ ) S.S.

AFFIDAVIT OF LOSS

I, ____________________, of legal age, single/married, with residence and postal

address at, ____________ after being duly sworn to in accordance with law, hereby
depose and say that:

1. I am a true and lawful owner of ______________.

2. Sometime last _________ said __________ was misplaced and got lost
_________________.
3. Diligent efforts have already been exerted to locate and/or retrieve the said
_______________, but despite such efforts, the same could not be found and is
now beyond recovery.
4. Said ____________ has not been confiscated by any officers of the government for
any violation;
5. I am executing this Affidavit of Loss to attest to the truth of the foregoing and for
whatever legal purpose it may serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, we have hereunto set our hands

this __________________, at _____________________, Philippines.

_______________
Affiant

SUBCRIBED AND SWORN TO before me this in _

City, Philippines, affiant exhibiting to me his _______________ issued in and
valid until __________.

Doc. No.: _________;

Page No.:_________;
Book No.:_________;
Series of 20________.

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01 Affidavit of Loss

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01 Affidavit of Loss

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REPUBLIC OF THE PHILIPPINES )

Municipality / City of _______________ ) S.S.

I, ____________________, of legal age, single/married, with residence and postal

1. I am a true and lawful owner of ______________.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, we have hereunto set our hands

SUBCRIBED AND SWORN TO before me this in _

Doc. No.: _________;

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01 Affidavit of Loss

Uploaded by

01 Affidavit of Loss

Uploaded by

REPUBLIC OF THE PHILIPPINES )

Municipality / City of _______________ ) S.S.

I, ____________________, of legal age, single/married, with residence and postal

1. I am a true and lawful owner of ______________.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, we have hereunto set our hands

SUBCRIBED AND SWORN TO before me this ________ in _________

Doc. No.: _________;

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Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

SUBCRIBED AND SWORN TO before me this in _