An affidavit of loss is a written statement under oath where a person (the “affiant”) declares the particulars and circumstances of the physical loss of a property. It is usually required when the owner wants to have the lost item replaced with a new one. Once the affidavit is sworn to before a notary public or other officers authorized to administer an oath, it holds the force of law and binds the affiant to the truthfulness of the information that he or she has provided. It is thus vital that individuals thoroughly read and understand all of the information contained in the affidavit before signing it.
REPUBLIC OF THE PHILIPPINES)
CITY OF MAKATI ) S.S.
x------------------------------------------------x
AFFIDAVIT OF LOSS
I, LUCIA L. TAN, of legal age, Filipino, single and a resident of 2222
Washington Street, Pio del Pilar, Makati City, after having been duly sworn to
in accordance with law, depose and state:
1. That I am a holder of Automated Teller Machine
(ATM) Card No. 123456789 duly issued in my favor by Banco de Oro Unibank, Inc.
on January 12, 2010 in Makati City;
2. That I used to put said ATM card in my wallet;
3. That sometime on July 20, 2021, when I
arrived home from work, I discovered that said ATM card was no longer in my
wallet;
4. That diligent effort to locate the same
proved futile;
5. That in view thereof, I now desire and
hereby request BDO to issue another ATM card in lieu of the lost one;
6. That I bind myself to save BDO harmless
from any loss or damage that it may incur in connection with the issuance of a
new ATM card in lieu of the lost one;
7. That I am executing this affidavit to
attest to the foregoing facts and for any legal purpose it may serve.
IN WITNESS
WHEREOF, I have hereunto set my hand this 29th day of
July 2021 in Makati City, Metro Manila, Philippines.
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LUCIA L.
TAN
Affiant
Voter's ID
No. 5555
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SUBCRIBED AND
SWORN TO before me this 29th day of July 2021 in Makati
City, Metro Manila, Philippines, affiant exhibiting to me his valid proof
of identification.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2021.
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