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Affidavit of Loss Card

The affiant lost their debit/credit card and is filing an affidavit of loss to request that their bank issue a replacement card. They state that they discovered the card was missing from their bag on December 16, 2020 after arriving home. Despite searching, they were unable to locate the lost card. The affiant agrees to hold the bank harmless for any losses incurred by issuing a new replacement card.

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538 views1 page

Affidavit of Loss Card

The affiant lost their debit/credit card and is filing an affidavit of loss to request that their bank issue a replacement card. They state that they discovered the card was missing from their bag on December 16, 2020 after arriving home. Despite searching, they were unable to locate the lost card. The affiant agrees to hold the bank harmless for any losses incurred by issuing a new replacement card.

Uploaded by

kerovreporting
Copyright
© © All Rights Reserved
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

AFFIDAVIT 

OF LOSS 

         I_______ , of legal age, Filipino, single and a resident Of ______Cabuyao


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

1. That I am a holder an __ Card issued by____ branch

2. That I used to put said__ Card in my bag

3. That sometime on December 16, 2020, when I arrived home, I discovered that
my___ card was no longer in my bag

4. That diligent effort to locate the same proved futile;

5. That in view thereof, I now desire and hereby request___ Branch to issue
another ___ card in lieu of the lost one;

6. That I bind myself to save ______________ harmless from any loss or damage that


it may incur in connection with the issuance of a new card in lieu of the lost one;

7. That I am executing this affidavit to attest to the foregoing facts and for any legal
purpose it may serve.

         IN WITNESS WHEREOF, I have hereunto set my hand this 18th day of


December 2020 in Pasay City, Metro Manila, Philippines.
    

Affiant

    SUBCRIBED AND SWORN TO before me this 18thday of December


2020 in Pasay City,Metro Manila, Philippines, affiant exhibiting to me his valid proof
of identification.
Doc. No. _____;

Page No. _____;

Book No. _____;

Series of 2020. 

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