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Affidavit of Loss - (CSB) ATM (Without Noticed)

The document is an affidavit of loss filed by Josie E. Dela Cruz regarding her lost City Savings Bank ATM card. She details keeping the card in her wallet and drawer, but recently realizing it was missing and could not be found. She is requesting the bank issue a new ATM card in place of the lost one and holds the bank harmless for any issues replacing the card.

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john kristoffer cananes
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152 views2 pages

Affidavit of Loss - (CSB) ATM (Without Noticed)

The document is an affidavit of loss filed by Josie E. Dela Cruz regarding her lost City Savings Bank ATM card. She details keeping the card in her wallet and drawer, but recently realizing it was missing and could not be found. She is requesting the bank issue a new ATM card in place of the lost one and holds the bank harmless for any issues replacing the card.

Uploaded by

john kristoffer cananes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republic of the Philippines)

City of Tacloban ) s.s.


Province of Leyte )
x-------------------------------x

AFFIDAVIT OF LOSS

I, JOSIE E. DELA CRUZ, of legal age, married, Filipino and a resident of


Brgy. Guinmaayohan, Balangiga, Eastern Samar, after having been duly sworn
to in accordance with law do hereby depose and say;

1. That I am a holder of City Savings Bank (CSB) ATM Card with business
address located at Salazar St., Tacloban City;

2. That above-mentioned ATM card was kept in my possession and was


placed in my wallet with some of my other ID’s;

3. That above-mentioned ATM Card was kept inside my drawer,


however, just recently when I was to make use of it I noticed that the same
could no longer be found believed to have been misplaced;

4. That I have made diligent efforts to locate above-mentioned ATM


card and but the same have proven futile, hence, for all intent and legal
purposes I considered it lost and beyond recovery;

5. That in view thereof, I am now requesting the of City Saving Bank


(CSB), Salazar St., Tacloban Branch, to issue another ATM card in lieu of the
lost one;

6. That I hereby hold the City Savings Bank (CSB), Salazar St., Tacloban
City Branch, free and harmless from any loss or damage that it may incur by
reason of or in connection with the issuance of a new ATM card;

IN WITNESS WHEREOF, I have hereunto affix my signature this 17 th day of


April 2018 at Tacloban City.

JOSIE E. DELA CRUZ


Affiant

SUBSCRIBED AND SWORN to before me this this 17th day of April 2018 at
Tacloban City. Affiant exhibited to me her TIN ID with No. 289-071-909-000
issued on 02-03-2010.

Doc. No. ____


Page No. ____
Book No. ____
Series of 2018

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