AFFIDAVIT OF LOSS - IDENTIFICATION CARD 

BASIC PHILIPPINE LEGAL FORMS

When executing an affidavit of loss, it is important that the affiant attest that the thing subject of the affidavit of loss was not confiscated by the officers of the law or officers of the issuing body or agency due to any violation of a law, statute or other rules and regulation.

REPUBLIC  OF  THE PHILIPPINES)

CITY       OF   _______                     )S.S.

X - - - - - - - - - - - - - - - - - - - - - - - -X

AFFIDAVIT OF LOSS

I, ___________, Filipino, of legal age, single/married and a resident of __________________________, Philippines, after having duly sworn to in accordance with law, hereby depose and say that:

1. I am a holder of a student Identification Card issued by _____________________________ ;

2. I lost said Identification Card on ____________________ and that I exerted all efforts to locate the same but I could not remember exactly where I placed/left it and it is considered lost for all legal purposes;

3. Said Identification Card was not confiscated by any officer of the law or the officers of (name of school) by reason of any violation of any law, ordinance, presidential decree or rules and regulation of said university; and neither was it offered as collateral for any loan;

4. I am executing this affidavit to attest to the foregoing facts;

IN WITNESS WHEREOF, I have hereunto set my hand this ______________ in the City of _____________, Philippines.

________________ 

Affiant

SUBSCRIBED AND SWORN to before me this _______________ in the City of __________, Philippines, affiant having exhibited to me his/her community tax certificate with no. __________________ issued on _________________ at ______________ .

Doc. No. ________;

Page No. ________;

Book No.________;

Series of 2006.

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