Affidavit of Loss

I, (Pangalan), Filipino, of legal age, presently residing at (Address ), after having been sworn to in accordance with law hereby depose and state:

1. That the Land Transportation Office issued to me a Driver’s License with No. 123456789

(Note: Ilagay ang bagay na nawala at kung kanino nanggaling, e.g., birth certificate-NSO, company ID-Company name, etc.)

2. That sometime in (buwan kung kelan nawala o ilagay ang tamang araw kung  alam mo kelan) of this year, I was looking for the (bagay na nawala) but to my surprise, said (bagay na nawala) could not be found;

3. That I took pains to look for said (bagay na nawala), but to no avail;4. That I am executing this affidavit to attest to the truth of the foregoing and to request from the Land Transportation Office of Quezon City, a new Driver’s Licence.

(Note: Ilagay ang dahilan kung bakit ginawa o purpose ng affidavit) 

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of _______________. 20___ at _________________________.


(Name Over Signature of Affiant)

REPUBLIC OF THE PHILIPPINES)
_________________________ ) S.S

SUBSCRIBED AND SWORN to before me, this ____ day of ______________, 20___ in ___________________ City, with affiant exhibiting his CTC No. _______________ , Issued on ______________________ at _________________________.

6 responses to “Affidavit of Loss

  1. Mayeth Pangilinan

    Please kindly send me an example of Affidavit of Loss Title …thanks

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  3. pano po kung cheque?

  4. sir ask lang po ako kasi nawala ung dismissal letter from court paano po ba ako mkakakuha nung panibagong kopya ? ..

  5. sir gud day po,ask ko lang po nung pwd gwin sa kabit ng tatay,kasi ngsasama cla ngun sa saudi,pekeng marriage contract gmit nila,nsasaktan po nanay ko kasi gnwa n xang patay dun sa marraige contract nila,matagal n pnahon kmi nahahahimik,hnggng sa ngun lang kami ng lakas loob kasi umuwi tatay ko nun,nkuha ng mama ko ung copya ng marriage contract nila kuno. natwag pa tatay ko last year,pero never kami pinadalhan,kaya sariling sikap kmi,tas ngun ntwag kami sa number n gamit nya babae nsagot at binababaan kami,pwd b namin cla padeport,tutal nd nmn kami nasusustentuhan dati pa,,maraming salamat po,

  6. carla ramirez

    gud evning sir aqo nga po pala c carla my ron po aqong gs2ng itanong sir i2 po ang aking kwento meron po kcing babae na nanggugulo sa amin dahil po iyon sa pagtitinda ang pinagtataka ko lang po lagi ho syang nagpapabarangay o nagdedemanda o nagpapapulis kahit wala naman po kaming ginagawang masama tapos po meron po ciya palaging may dalang bata at ang ginagawa nya po eh tinuturuan nya po ng kcinungalingan ang kanyang anak eh lagi nya po kaming pinagbibintangan na cinasaktan namin ng kanyang anak eh sa isip2 namin kaya niya tinuturuan ang kanyang anak ng kasamaan eh para masolo nya ang pagtitinda o ang pwesto namin o di kaya gus2 lang magkapera sir bigyan nyo po ko ng kasagutan kung paano mabibigyan ng leksyon ang magnanay na i2 maraming salamat po

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