Scribd
Upload
313 views2 pages

Affidavit of Loss for Vehicle License Plate

This affidavit of loss was sworn by Ryan Rendal, a driver for Keramix Specialty Products Inc. Rendal states that on August 5, 2020 the rear license plate of the truck he was driving, a Racal Dionysus with engine and chassis numbers provided, was lost somewhere in Olongapo City despite diligent search efforts. Rendal executes this affidavit to attest to the truth of the loss and support an application for a new license plate.

Uploaded by

lucky
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
313 views2 pages

Affidavit of Loss for Vehicle License Plate

This affidavit of loss was sworn by Ryan Rendal, a driver for Keramix Specialty Products Inc. Rendal states that on August 5, 2020 the rear license plate of the truck he was driving, a Racal Dionysus with engine and chassis numbers provided, was lost somewhere in Olongapo City despite diligent search efforts. Rendal executes this affidavit to attest to the truth of the loss and support an application for a new license plate.

Uploaded by

lucky
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

Republic 

of the Philippines )
Province of ____________________) S.S.
City/Municipality of ______________)

AFFIDAVIT OF LOSS

I, Filipino, of legal age, single, and a resident of Mabuhay Textile, Malinta,


Valenzuela City, Philippines, after being duly sworn in accordance with law, depose and
state:
That I am the Driver of a Utility Vehicle/Elf, under the ownership of Keramix Specialty
Products Inc. more particularly described as follows:
Make & Series: Isuzu
Engine No. : 4BE1-152725
Chassis No. : ENKR-20050256-C
Plate No. : ZGJ749

That on or about August 1, 2020 , somewhere in Bocaue, Bulacan the rear license
plate of the said utility vehicle was lost;
That despite diligent search and efforts to locate the said license plate, I could not
find the same such that I now believe that they are now lost beyond recovery.
As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support the application for the issuance of a new one in lieu of the one that was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at
_____________, Philippines.

Affiant
DL No. _________________

SUBSCRIBED AND SWORN TO before me this _________________ at


________________________. Affiant exhibited to me her competent evidence of identity
written immediately below his name.

Notary Public

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2020.
Republic of the Philippines )
Province of ____________________) S.S.
City/Municipality of ______________)

AFFIDAVIT OF LOSS

I, RYAN RENDAL, Filipino, of legal age, single, and a resident of Mabuhay Textile,


Malinta, Valenzuela City, Philippines, after being duly sworn in accordance with law, depose
and state:
That I am the Driver of a Truck, under the ownership of Keramix Specialty Products
Inc. more particularly described as follows:
Make & Series: RACAL DIONYSUS
Engine No. : YC4D12021D12F8G00008
Chassis No. : LWU5PM3C9GKM00150
Plate No. : CAH-2396

That on or about August 5, 2020 , somewhere in Olongapo City the rear license
plate of the said utility vehicle was lost;
That despite diligent search and efforts to locate the said license plate, I could not
find the same such that I now believe that they are now lost beyond recovery.
As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support the application for the issuance of a new one in lieu of the one that was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at
_____________, Philippines.

RYAN RENDAL
Affiant
DL No. _________________

SUBSCRIBED AND SWORN TO before me this _________________ at


________________________. Affiant exhibited to me her competent evidence of identity
written immediately below his name.

Notary Public

Doc. No. ____;


Page No. ____;
Book No. ____;
Series of 2020.

You might also like