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Affidavit of Loss - Passport - No ID

1) The affidavit establishes that the affiant, XXXXXXXXXXXXX, lost his driver's license receipt that was issued by the Land Transportation Office in September 2017. 2) The receipt had always been kept in the affiant's wallet until September 2018 when he was pickpocketed in Malolos, Bulacan, causing him to lose his wallet and receipt. 3) Despite efforts to locate the lost receipt, it remains lost. The affiant executed this affidavit to attest to the truth of the loss and to support his application for a new driver's license.

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Klieds Cunanan
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313 views1 page

Affidavit of Loss - Passport - No ID

1) The affidavit establishes that the affiant, XXXXXXXXXXXXX, lost his driver's license receipt that was issued by the Land Transportation Office in September 2017. 2) The receipt had always been kept in the affiant's wallet until September 2018 when he was pickpocketed in Malolos, Bulacan, causing him to lose his wallet and receipt. 3) Despite efforts to locate the lost receipt, it remains lost. The affiant executed this affidavit to attest to the truth of the loss and to support his application for a new driver's license.

Uploaded by

Klieds Cunanan
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
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REPUBLIC OF THE PHILIPPINES )

PROVINCE OF PAMPANGA )S.S.


MUNICIPALITY OF GUAGUA )

AFFIDAVIT OF LOSS

I, XXXXXXXXXXXXXXXXXXXX, of legal age, Filipino, married, with residence at


Rizal, Guagua, Pampanga after having been duly sworn to in accordance with law,
hereby depose and say, that:

1. I am the lawful owner of a Driver’s LicenseReceipt issued by the Land


Transportation Office in San Fernando, Pampanga sometime in September
2017;

2. Said receipt was always kept in my wallet;

3. Sometime in September 2018, I was a victim of pick pocketing in Malolos,


Bulacanand I lost my wallet containing the said receipt;

4. Despite diligent efforts exerted by me to locate the same, all proved in vain, thus,
I now consider it as lost for all intents and purposes.

5. I have executed this affidavit to attest to the truth of the foregoing and to serve as
a supporting document for my application for the issuance of a drivers license
and for any other legal purpose(s) it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 2nd day of


October2018 in Guagua,Pampanga, Philippines.

XXXXXXXXXXXXXX
Affiant

SUBSCRIBED AND SWORN to before me this 2nd day of October 2018, in


Guagua, Pampanga Philippines, by xxxxxxxxxxxxxxx whose identity has been
satisfactorily proven to me through Noel Gorobat exhibiting to me his AFP id card with
no. xxxxxxxxxxxxxxxx and xxxxxxxxxxx exhibiting his Police Clearance Id Card
xxxxxxxxxxxxxxxxxx6 who personally know the affiant as the same person who
executed and personally signed before me this affidavit.

WITNESS MY HAND AND SEAL OF OUR OFFICE.

CONTROL No.
xxxxxxxxxxxxxxxxxx
Public Attorney II
(Pursuant to R.A. No. 9406)

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