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Affidavit of Loss
Affidavit of Loss
__________,_____________ ) S.S.
AFFIDAVIT OF LOSS
2. I have recently discovered the said item is irretrievably lost and can no longer be found despite
diligent efforts to locate the same;
Affiant
Princess Diane F. Dela Peña
Competent evidence of identity
ID:
Issued on:
at:
SUBSCRIBED and SWORN TO before me on the date and at the place indicated below. The affiant
exhibited to me her confident evidence of identity as given above.
Notary Public
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