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Affidavit of Loss

The document is an affidavit of loss from a person in the Philippines about losing an item. It details when and how the item was lost and that despite efforts to find it, it remains lost. The person requests a replacement for the lost item.

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Lizza Bartolata
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33 views2 pages

Affidavit of Loss

The document is an affidavit of loss from a person in the Philippines about losing an item. It details when and how the item was lost and that despite efforts to find it, it remains lost. The person requests a replacement for the lost item.

Uploaded by

Lizza Bartolata
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 Masbate ) S.S


Municipality of San Jacinto

AFFIDAVIT OF LOSS

I, (name ), Filipino, of legal age and residing at _______, after having been sworn
according to law, hereby depose and state that:

I. I am the owner of (thing lost) with _____ issued on ______ by ______.


II. On or about ___________, I discovered the loss of the said (-----)
under the following circumstances:

____________________________________
____________________________
III. Despite diligent efforts, I could not find nor locate the same and
believe that it is truly lost.
IV. I am executing this affidavit for whatever legal purpose it may
serve and request for a replacement of said (---).

_______________________
(AFFIANT)

SUBSCRIBED AND SWORN to before me this (date) at San Jacinto, Masbate,


affiant (name ) , personally appeared before me and exhibited to me (ID
presented) and is valid until (date of exp.).

Notary Public
Doc. No.______;
Page No. ______;
Book No.______;
Series of 2022

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