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    Affidavit of Loss - Passbook

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    Alfie Omega
    Eden D. Juntilla swore in an affidavit that he lost his passbook issued by the Tagum Cooperative on December 4, 2018 despite searching for it. He executed the affidavit to establish the fact of the loss and to request a reissuance of the passbook. The affidavit was sworn before a notary public in Tagum City, Davao del Norte, Philippines on an unspecified date.

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    Affidavit of Loss - Passbook

    Uploaded by

    Alfie Omega
    2K views1 page
    Eden D. Juntilla swore in an affidavit that he lost his passbook issued by the Tagum Cooperative on December 4, 2018 despite searching for it. He executed the affidavit to establish the fact of the loss and to request a reissuance of the passbook. The affidavit was sworn before a notary public in Tagum City, Davao del Norte, Philippines on an unspecified date.

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    PASSBOOK

    Original Title

    Affidavit of loss--passbook

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    Eden D. Juntilla swore in an affidavit that he lost his passbook issued by the Tagum Cooperative on December 4, 2018 despite searching for it. He executed the affidavit to establish the fact of the loss and to request a reissuance of the passbook. The affidavit was sworn before a notary public in Tagum City, Davao del Norte, Philippines on an unspecified date.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    2K views1 page

    Affidavit of Loss - Passbook

    Uploaded by

    Alfie Omega
    Eden D. Juntilla swore in an affidavit that he lost his passbook issued by the Tagum Cooperative on December 4, 2018 despite searching for it. He executed the affidavit to establish the fact of the loss and to request a reissuance of the passbook. The affidavit was sworn before a notary public in Tagum City, Davao del Norte, Philippines on an unspecified date.

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    © All Rights Reserved
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    Republic of the Philippines )

    Province of Davao del Norte )ss.


    x - - - - - - - - - - - - - - - - - -x

    AFFIDAVIT OF LOSS

    I, EDEN D. JUNTILLA, of legal age, Filipino, married to Jan


    Nieve G. Juntilla, and a resident of Purok 3, La Filipina, Tagum City,
    Davao del Norte, Philippines, after having been duly sworn to in
    accordance with law, hereby depose and say:

    That I am a holder of a Passbook duly issued by the Tagum


    Cooperative;

    That the said Passbook was lost last December 4, 2018 and
    can no longer be located despite earnest efforts I have exerted to
    find the same;

    That I am executing this Affidavit to establish the fact of loss


    and in connection with the requirement for its re-issuance.

    IN WITNESS WHEREOF, I have hereunto set forth my


    hand this ______________________ at Tagum City, Davao del
    Norte, Philippines.

    EDEN D. JUNTILLA
    Affiant
    UMID CARD: CRN-0111-3621446-8

    SUBSCRIBED AND SWORN TO BEFORE ME this


    ___________________ at Tagum City, Davao del Norte,
    Philippines. Affiant personally appeared to me exhibiting his
    evidence of identity as reflected below his name as competent
    proof of his identity.

    Doc. No. _____;


    Page No. _____;
    Book No. _____;
    Series of 2018.

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