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Affidavit of Loss - Taytay

Basilia Gan executed an affidavit of loss to attest that she lost her BIR TIN card, PhilHealth identification card, and postal identification card when she discovered they were missing from her wallet while at the public market on May 13, 2017. Despite searching, she was unable to find the cards and believes them to be lost beyond recovery. She signed the affidavit to request replacements of the cards from the respective agencies and for any legal purposes.

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694 views

Affidavit of Loss - Taytay

Basilia Gan executed an affidavit of loss to attest that she lost her BIR TIN card, PhilHealth identification card, and postal identification card when she discovered they were missing from her wallet while at the public market on May 13, 2017. Despite searching, she was unable to find the cards and believes them to be lost beyond recovery. She signed the affidavit to request replacements of the cards from the respective agencies and for any legal purposes.

Uploaded by

aldin
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 )

_______________________________ ) S.S

AFFIDAVIT OF LOSS

I, BASILIA GAN, of legal age, Filipino, widow and a resident of


Poblacion, Taytay, Palawan, after having been duly sworn in
accordance with law, hereby depose and say:

1. That I am a holder of a BIR TIN card, PhilHealth identification card


Postal identification card;

2. That I used to put said identification cards inside my wallet;

3. That sometime on May 13, 2017, at around ten (10) oclock in


the morning at New Public Market at Poblacion, Taytay, Palawan, I
discovered that the above-mentioned identification cards was no
longer in my wallet where I used to place it;

4. That despite diligent search and efforts to locate the said


identification cards, I could not find the same such that I believe
that it is now lost beyond recovery;

5. That said identification cards was not confiscated by the


authorities or used in violation of the law;

6. That I am executing this affidavit to attest to the truth of the


foregoing facts and to request for a replacement of the above-
mentioned identification cards from the respective agency and
for whatever legal purposes it may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature


__________________ in _________________________.

BASILIA GAN/Affiant
Id No: ____________/_____________

SUBCRIBED AND SWORN TO before me this _________________ in


________________________, affiant exhibiting to me her valid proof of
identification as indicated below her name.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2017.

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