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Affidavit of Loss - Bank Passbook - Metrobank

Lilian T. Gabon lost her Metropolitan Bank and Trust Company passbook with account number 007116510347 on September 15, 2021. She searched everywhere she may have placed her bag containing the passbook but was unable to find it. She executed an affidavit of loss on September 22, 2021 to attest that the loss was not intentional and to request a replacement passbook from the bank.

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Affidavit of Loss - Bank Passbook - Metrobank

Lilian T. Gabon lost her Metropolitan Bank and Trust Company passbook with account number 007116510347 on September 15, 2021. She searched everywhere she may have placed her bag containing the passbook but was unable to find it. She executed an affidavit of loss on September 22, 2021 to attest that the loss was not intentional and to request a replacement passbook from the bank.

Uploaded by

acubalawoffice acuba
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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REPUBLIC OF THE PHILIPPINES.

)
PROVINCE OF SAMAR……………) SS.
CITY OF CATBALOGAN………..… )

AFFIDAVIT OF LOSS

I, LILIAN T. GABON, of legal age, single, Filipino and with present address at Patag
Poblacion 13, Catbalogan City, Samar, after having been duly sworn to in accordance with law
do hereby depose and state that:

1. I am a holder of Metropolitan Bank and Trust Company (MBTC) passbook


holder with account no. 007116510347;

2. Unfortunately, however, in September 15, 2021, said passbook which was


then contained in my bag was misplaced thereat; I then tried and exerted
efforts to locate the said passbook in every corner of places where I probably
placed it, but to no avail and the same proved futile such that after a
reasonable time that elapsed, I know consider it lost for all intents and
purposes;

3. The fact of loss is not intended to defraud the Metropolitan Bank and Trust
Company (MBTC) and third persons nor in perpetration of anything
unlawful, and I hereby absolve said offices of any liabilities or
responsibilities arising from said loss;

4. I am executing this statement to attest the truth of all the foregoing, to request
for replacement of said passbook and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 22 nd day of September 2021


at Catbalogan City.

LILIAN T. GABON
Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of September 2021 at


Catbalogan City, Samar, affiant exhibiting to me his Driver’s License ID No. H01-04-025759
valid until September 14, 2024

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