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Affidavit of Loss-ATM

The affiant executed an affidavit of loss to attest that their LandBank ATM card was lost. They state that while shopping at a mall, they noticed their wallet containing the ATM card was missing from their bag. Despite searching the mall diligently, they were unable to find the lost wallet. The affiant is executing this affidavit to support their application for a new ATM card to replace the one that was lost.

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Rothea Simon
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588 views1 page

Affidavit of Loss-ATM

The affiant executed an affidavit of loss to attest that their LandBank ATM card was lost. They state that while shopping at a mall, they noticed their wallet containing the ATM card was missing from their bag. Despite searching the mall diligently, they were unable to find the lost wallet. The affiant is executing this affidavit to support their application for a new ATM card to replace the one that was lost.

Uploaded by

Rothea Simon
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 )
City of )s.s
x-------------------------------x

AFFIDAVIT OF LOSS

I, __________, 33 years old, Filipino, married, and a resident of


___________________, Philippines, after having been duly sworn to in
accordance with law, do hereby depose and state THAT:

1. I am the same person whose circumstances stated above;

2. I am a holder of a LandBank-ATM Card issued by the LandBank of


the Philippines;

3. Sometime on 03 October 2019, when I was strolling inside the Mall,


I noticed that I my wallet placed inside my bag where I put my atm
card was missing;

4. Upon discovery of the same, I decided to look for it and went back
to where I have been and gone through the Mall;

5. Despite diligent search and effort to retrieve my wallet, I could not


find the same that I now believe that it is beyond recovery;

6. As such, I am executing this affidavit to attest of the truth of the


foregoing statement and to support my application for issuance of
new one in lieu of the one which was lost.

IN WITNESS WHEREOF, I hereunto set my hand this


______________, Philippines.

Affiant

SUBSCRIBED AND SWORN to before me this _____________


Philippines, affiant exhibiting to me her competent evidence of identity
written below her name and signature.

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