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Affidavit of Loss
Affidavit of Loss
Affidavit of Loss
CITY OF MAKATI
) S.S.
x----------------------------------x
AFFIDAVIT OF LOSS
I,
___________________, of
legal
age,
Filipino,
single
and
resident
of
_______________________________, after having been duly sworn to in accordance with law, depose and
state THAT:
1. On January 12, 2010, I was issued a Philippine Passport by the Department of Affairs in Manila;
2. Recently, I had tried to look for the said passport but the same could not be found;
3. Despite diligent search and efforts to locate the said passport, I could not find the same such that I believe that
it is now lost beyond recovery;
4. As such, I am executing this affidavit to attest to the foregoing facts and to support the application for the
issuance of a new one in lieu of the one which was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Makati City,
Metro Manila, Philippines.
____________________
Affiant
GSIS ID No. _____________
SUBCRIBED
AND
SWORN
TO before
me
this ___________________ in