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Loss Senior Citizen Id & Purchase Slip Booklet - Butron

Nicolas M. Butron executed an affidavit stating that (1) he is a holder of a senior citizen ID and purchase slip booklet that (2) went missing in March 2021. Despite diligent efforts, he was unable to find or recover the documents. Therefore, he considers them lost and (3) is requesting new documents to replace the lost ones.

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90 views1 page

Loss Senior Citizen Id & Purchase Slip Booklet - Butron

Nicolas M. Butron executed an affidavit stating that (1) he is a holder of a senior citizen ID and purchase slip booklet that (2) went missing in March 2021. Despite diligent efforts, he was unable to find or recover the documents. Therefore, he considers them lost and (3) is requesting new documents to replace the lost ones.

Uploaded by

ralplagura
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 Bohol ] S.S.


Municipality of Carmen ]

AFFIDAVIT OF LOSS
(Re: Senior Citizen ID & Purchase Slip Booklet)

I, NICOLAS M. BUTRON, Filipino, of legal age, married and a resident of Bicao,


Carmen, Bohol, Philippines, after being duly sworn in accordance with law, hereby depose and
say:

1. That I am a holder of a Senior Citizen ID and a Purchase Slip Booklet;

2. That said Senior Citizen ID and Purchase Slip Booklet got lost last March 2021;

3. That I exerted diligent efforts to find and recover the aforesaid Senior Citizen ID and
Purchase Slip Booklet, however, my efforts proved futile as until now, its
whereabouts still could not be ascertained, hence, I considered it to be lost for all
intents and purposes;

4. That the said Senior Citizen ID and Purchase Slip Booklet was not transferred to any
person for consideration or used as collateral to secure obligations;

5. That I execute this affidavit voluntarily to attest to the truth of the foregoing
statements to support my request for the issuance of another Senior Citizen ID and
Purchase Slip Booklet in lieu of the lost one;

6. That further, I execute this affidavit for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I hereunto set my hand this 28th day of July, 2021 at
Carmen, Bohol, Philippines.

NICOLAS M. BUTRON
Affiant
Driver’s License No. N06-61-017060
Issued by LTO

SUBSCRIBED AND SWORN TO before me this 28th day of July, 2021 at Carmen,
Bohol, Philippines.

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