Legal Forms
AFFIDAVIT OF LOSS
12:50 AM
The
following are the MADE SIMPLE steps; (PNP)
1.
PREPARE your Affidavit of Loss, state the following:
a.
Your
personal circumstances. (name, age, civil
status and address)
b. Describe
the item/document lost. (Ownership, issuing office, date of issuance, place of issuance, if any)
c. Approximate date and time of loss
d. Briefly state on how the item/document
got lost or was probably lost.
e. That
diligent search proved futile and unavailing
f.
That
it has not been confiscated by any officer of the law or the issuing office or
agency due to the violation of any law, statute, order, rule or regulation.
2. Have it NOTARIZED, either
a. Notary public
b. Government officer authorized to
administer oaths
Note:
Bring any valid ID or government issued
ID
3. PRESENT it to the concern agency or office
AFFIDAVIT OF LOSS
REPUBLIC OF THE
PHILIPPINES )_____________________________ ) SS.
I, _____________________________,
Filipino, of legal age, single/married to _____________________________,
and a resident of _____________________________, after having been duly
sworn in accordance with law, hereby depose and say:
1.
That I am a holder of a school/company identification card bearing serial number ______________________ issued
by _____________________________;
2.
(State the circumstances
leading to the loss of the ID, e.g.:) That I used to put said
identification card in my pouch, among others;
3.
That sometime on _____________________________, when I arrived home from
work, I discovered that my school/company ID card was no longer in my pouch
where I used to place it;
4.
That diligent effort to locate the same had proved futile; (alternative statements:
Diligent search of said document proved futile and unavailing; Despite diligent
search and efforts to locate said document, I could not find it, etc.)
5.
That said school/company ID card was not confiscated by the authorities
of _____________________________ by reason of any violation of
school/company rules and regulations;
6.
That I am executing this affidavit to attest to the truth of the foregoing
facts and to request for a replacement of said school/company ID card
from _____________________________.
IN WITNESS WHEREOF, I have hereunto affixed my signature
this ____ day of ____________ 20___ at ________________________, Philippines.
______________________________________
(Signature of Affiant over Printed
Name)
Notary Public
Until 31 December 20___
PTR No. __________
Doc. No. _______
Issued at:
__________
Page No. _______
Issued
on: __________
Book No. _______
TIN
No. ___________
Series of ________
DISCLAIMER: The author is not lawyer nor an authority on this topic. It is a product of humble research and study of law. It should not be used as sole basis in filing a case, instead, consult your lawyer for proper legal advice.
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