Professional Documents
Culture Documents
Affidavit of Loss LTO VFS 488
Affidavit of Loss LTO VFS 488
Affidavit of Loss LTO VFS 488
CITY OF DAVAO
x------------------------------------------x
AFFIDAVIT OF LOSS OR
I, Rinabeth L. Arellano of legal age, married, Filipino and resident of Lot 3586-1 Purok San
Andres< Barangay Indangan, Davao City, after having been sworn to in accordance with law, hereby
depose and state:
2. That, as proof of ownership of the above described motorcycle I was issued by the Land
Transportation Office, Official Receipt (OR) as proof of payment and Certificate of Registration
(CR);
3. That the said documents while in my possession were misplaced and could no longer be located
inspite of exerting efforts of locating them;
4. That the said documents were not in the possession of any bank institutions or lending companies
by reason of encumbrance or chattel mortgage of the subject vehicle;
5. That the said documents were not confiscated by any government authorities in violation of R.A.
4136 and other related laws;
6. That I shall assume any responsibilities or liability if any event I will use these documents for
whatever elicit transactions;
7. That I am executing this affidavit to attest to the veracity of my statement and to support the same
in its request for duplicate copies of the lost OR/CR at the Land Transportation Office (LTO)
where is has a hand over subject;
8. That I bind myself criminally civilly and administratively liable and will assume full
responsibility for any 3rd party claim, and I hereby hold the Land Transportation Office or any of
its employees free from any liability arising from any claim for damages as a result of the
registration of the vehicle and or issuance of replacement certificate of registration.
Rinabeth L. Arellano
Affiant
CRN – 0009-2034937-5