REPUBLIC OF THE PHILIPPINES )
_______________________________, _______________________________ ) S.S.
AFFIDAVIT OF LOSS
I, ________, with the following nationality: Filipino, of legal age, and residing at: ________, after having been sworn according to law, hereby depose and state that:
1. I am the owner of a school ID with student no. ________ issued by ________.
2. On or about ________, I discovered the loss of the said school ID. I discovered the loss of the said under the following circumstances:
________
3. Despite diligent efforts, the same could not be found nor located and it is believed that the same is truly lost.
4. I am executing this affidavit for whatever legal purpose it may serve and to request for a replacement of the said school ID.
5. 5 522282 22 252 25525 22 252 225222822 82225252822.
8225885 2585858 588558 885285.
________
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at the City/Municipality of _______________________________ Province of _______________________________, personally appeared:
Affiant, ________ personally appeared before me and exhibited to me the following competent proof of identity: _______________________________________.
Doc. No.: _________;
Page No.: _________;
Book No.: _________;
Series of _________.
REPUBLIC OF THE PHILIPPINES )
_______________________________, _______________________________ ) S.S.
AFFIDAVIT OF LOSS
I, ________, with the following nationality: Filipino, of legal age, and residing at: ________, after having been sworn according to law, hereby depose and state that:
1. I am the owner of a school ID with student no. ________ issued by ________.
2. On or about ________, I discovered the loss of the said school ID. I discovered the loss of the said under the following circumstances:
________
3. Despite diligent efforts, the same could not be found nor located and it is believed that the same is truly lost.
4. I am executing this affidavit for whatever legal purpose it may serve and to request for a replacement of the said school ID.
5. 5 522282 22 252 25525 22 252 225222822 82225252822.
8225885 2585858 588558 885285.
________
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at the City/Municipality of _______________________________ Province of _______________________________, personally appeared:
Affiant, ________ personally appeared before me and exhibited to me the following competent proof of identity: _______________________________________.
Doc. No.: _________;
Page No.: _________;
Book No.: _________;
Series of _________.
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