Aaff of Loss Atm Cards

You might also like

Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 1

REPUBLIC OF THE PHILIPPINES)

QUEZON CITY ) S.S.

AFFIDAVIT OF LOSS

I, ROMELIO M. ARIZOBAL, of legal age, Filipino Citizen, residing at 48 Ilang-


ilang Street Green Valley Subd. Molino Bacoor Cavite, after having been duly sworn to
in accordance with law, hereby depose and state;

That I am the absolutely holder of ATM Card RCBC issued by Aeroplus Multi
Services Inc.;

That on April 14, 2008 the above-mentioned item was accidentally misplaced;

That after the diligent effort to locate the same but our effort found futile;

That I am executing this affidavit in order to attest the truth of the foregoing
facts and for all legal intents it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th day of April


2008 at Quezon City, Philippines.

ROMELIO M. ARIZOBAL,
Affiant

SUBSCRIBED AND SWORN to before me this 15th day of April 2008 at Quezon
City, Philippines.Affiant exhibited to me her CTC No. _______________issued on
____________________ at ________________________ Philippines .

Doc. No.: _____________ NOTARY PUBLIC


Page No.: _____________
Book No.: _____________
Series of 2008

You might also like