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Sample Affidavit of Loss of Pawn Ticket

Affidavit Affidavit of Loss



   I, ___________________, of legal age, Filipino, single and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. Sometime on ______________, I pawned my _________ with Tambunting Pawnshop located at _____________________ and for which I was issued Pawn Ticket/Receipt No. _________;

2. I kept the said pawn ticket in my wallet for safekeeping but unfortunately my wallet got lost;

3. Despite diligent search and efforts to locate the said wallet and pawn ticket, I could not find the same such that I believe that they are now lost beyond recovery; 

4. As such, I am executing this affidavit to attest to the foregoing facts and to enable me to secure a duplicate or substitute copy of the ticket and/or redeem the above-described item which I pawned.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in ____________Philippines.

GSIS ID No. _____________

  SUBCRIBED AND SWORN TO before me this ___________________ in _________________Philippines, affiant exhibiting to me his valid proof of identification.

Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2013.


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