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Loss Blank

This document is an Affidavit of Loss, where an individual declares the loss of a specific item despite diligent efforts to locate it. The affiant provides their personal details and the circumstances surrounding the loss, affirming the truth of the statement for legal purposes. The affidavit is to be notarized in Quezon City, Metro Manila.

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Carla Mae Acuña
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20 views1 page

Loss Blank

This document is an Affidavit of Loss, where an individual declares the loss of a specific item despite diligent efforts to locate it. The affiant provides their personal details and the circumstances surrounding the loss, affirming the truth of the statement for legal purposes. The affidavit is to be notarized in Quezon City, Metro Manila.

Uploaded by

Carla Mae Acuña
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 )

QUEZON CITY, METRO MANILA) SS.

AFFIDAVIT OF LOSS

I, ________________________________, of legal age, Filipino Citizen, with


residence and postal address at
____________________________________________________, after having been duly
sworn to in accordance with law, do hereby depose and states:

1. That I am the holder/possessor of _____________________________________


____________________________________________________________________;

2. That on ______________________ the said _____________________________


above mentioned was _______________________ despite diligent effort to
search cannot be found considered lost beyond recovery;

3. That I am executing this affidavit to attest to the truth of the foregoing


facts and circumstances and to hereby report to proper authorities
concerned for and mentioned and finally I execute the same for all legal
intents and purposes may served best.

IN WITNESS HEREOF, I hereunto affix my signature this


_________________________, in Quezon City, Metro Manila, Philippines.

________________________________
Affiant

SUBSCRIBED AND SWORN to before me, this _________________________


at Quezon City, Metro Manila, Philippines.

Doc. No. _______; Notary Public


Page No. _______;
Book No. _______;
Series of _______.

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