Professional Documents
Culture Documents
Affidavit of Loss
Affidavit of Loss
Affidavit of Loss
CITY OF QUEZON . . . . . . . . . . . . . . . ) S. S.
AFFIDAVIT
` 1. That I am a driver by profession, with License No. __________ issued by the Board of
Transportation at __________________.
2. That sometime on May 11, 2012, Friday, I lost my wallet and cellular phone at No. 96
B ROTC Hunters, Delgado Compound, Barangay Tatalon, Quezon City. In that wallet I lost all
my ID’s: SSS ID, Company ID, Philhealth ID, two ATM Cards, Driver’s License and a stub in
COMELEC to get my ID.
3. That I took pains to look for said wallet and cellular phone but to no avail.
4. That I am executing this statement to attest to all the above facts, and to request the
proper authorities to grant me new ID’s and license.
IN TRUTH WHEREOF, I have hereunto signed my name below, this ____ day of
______ 2012 at _________________.
SALVADOR SORIANO
Affiant