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    Affidavit of Loss - PhilHealth & SSS IDs

    Uploaded by

    Ma. Teresa Oliva
    The affiant lost their wallet on June 15, 2019 while taking a passenger jeepney home in Makati City. Inside the lost wallet were the affiant's PhilHealth ID and SSS ID. The affiant attests to the truthfulness of these statements and voluntarily executed this affidavit of loss on July 4, 2019 in Makati City.

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    © All Rights Reserved
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    Affidavit of Loss - PhilHealth & SSS IDs

    Uploaded by

    Ma. Teresa Oliva
    55 views1 page
    The affiant lost their wallet on June 15, 2019 while taking a passenger jeepney home in Makati City. Inside the lost wallet were the affiant's PhilHealth ID and SSS ID. The affiant attests to the truthfulness of these statements and voluntarily executed this affidavit of loss on July 4, 2019 in Makati City.

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    Affidavit of Loss

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    The affiant lost their wallet on June 15, 2019 while taking a passenger jeepney home in Makati City. Inside the lost wallet were the affiant's PhilHealth ID and SSS ID. The affiant attests to the truthfulness of these statements and voluntarily executed this affidavit of loss on July 4, 2019 in Makati City.

    Copyright:

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

    Affidavit of Loss - PhilHealth & SSS IDs

    Uploaded by

    Ma. Teresa Oliva
    The affiant lost their wallet on June 15, 2019 while taking a passenger jeepney home in Makati City. Inside the lost wallet were the affiant's PhilHealth ID and SSS ID. The affiant attests to the truthfulness of these statements and voluntarily executed this affidavit of loss on July 4, 2019 in Makati City.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    Republic of the Philippines )

    Makati City ) S.S.

    AFFIDAVIT OF LOSS

    I, ________________________, of legal age, married, presently


    residing at , Barangay Comembo, Makati City, after being sworn to in
    accordance with law, hereby depose and state:

    1. On June 15, 2019, I dropped my wallet at a passenger


    jeepney while on my way home.

    2. Inside the aforementioned wallet was my PhilHealth ID


    and SSS ID.

    3. Because of the said incident, I lost my wallet and all its


    contents, including my PhilHealth ID and SSS ID.

    4. I attest to the truthfulness of my statements above, and to


    the voluntary execution of this affidavit.

    IN WITNESS HEREOF, I have hereunto set my hand and


    signature this July 4, 2019, Makati City.

    ____________________________
    Affiant

    SUBSCRIBED AND SWORN to before me this 4 th day of July


    2019 in Makati City. The affiant exhibited to me his
    ____________________________________________, bearing his
    photograph and signature.

    Notary Public

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