REPUBLIC OF THE PHILIPPINES)
CITY OF MEYCAUAYAN, BULACAN) S.S.
AFFIDAVIT OF LOSS
I, CARLOS G. PRAICO, JR., Filipino, of legal age, married, and a resident
of 281 Silangan St. Caingin, City of Meycauayan Bulacan, after having been duly
sworn to in accordance with law, hereby state under oath that:
1. Recently, I lost the Certificate of Registration of my Yamaha Motorcycle
particularly described as follows:
CASE NO.: 2016-0219
MAKE: YAMAHA
MOTOR NO.: B115E-009938
CHASSIS NO.: B115E-009938
I tried to search for it at home and to all other possible places where it
could be, but unfortunately, I could no longer locate the same.
2. Despite diligent efforts to search for it, I am afraid that it is now beyond
recovery prompting me to state herein that it is irretrievably lost.
3. I am executing this Affidavit to attest to the truth of the foregoing
statements for all legal intents and purposes that this may serve.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I have here unto set my hand this 18th Day of
November 2020, in the City of Meycauayan, Bulacan.
CARLOS G. PRAICO, JR.
Affiant
SUBSCRIBED AND SWORN to before me this 18th Day of November 2020,
affiant exhibiting to me his Senior Citizen’s ID No. 30116 issued by OSCA.
Doc. No. _______;
Page No. ______;
Book No. ______;
Series of 2020.