AFFIDAVIT OF LOSS

I, _____________________, Filipino, of legal age, and residing at

_______________________________________, after having been sworn in
accordance with law, hereby depose and state:

1. I am presently enrolled as a Grade 11 student at ____________________

(“_______” hereafter);

2. I was previously issued a student identification card (the “subject document”

hereafter) by ______________;

3. However, on ___________________, I discovered my Student’s ID was no

longer attached to my lace;

4. Despite diligent search, the subject document is nowhere to be found and could
no longer be located/recovered; and

5. The undersigned affiant is executing this affidavit to attest to the truth of all the
foregoing, and for whatever legal purposes that it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this __th day of January
2020, in Cavite City, Cavite, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN to before me on this __th day of January 2020, in

Cavite City, the affiant showing to me his ___________ issued on ____________ at
____________.

NOTARY PUBLIC

Doc. No.____;
Page No.____;
Series of 2020.
 AFFIDAVIT OF LOSS

I, _____________________, Filipino, of legal age, and residing at

_______________________________________, after having been sworn in
accordance with law, hereby depose and state:

1. The undersigned had been issued a SSS ID by Social Security System under No.
_____________;

2. However, sometime in November, 2019, the wallet where my SSS ID has

been misplaced;

3. I have exerted diligent effort to locate the said ID but despite diligent search,
it is nowhere to be found and could no longer be recovered/ located; and

4. The undersigned affiant is executing this affidavit to attest to the truth of the
foregoing, and for whatever legal purpose (s) that this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this __th day of January
2020, in Cavite City, Cavite, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN to before me on this __th day of January 2020, in

Cavite City, the affiant showing to me his ___________ issued on ____________ at
____________.

NOTARY PUBLIC

Doc. No.____;
Page No.____;
Series of 2020.
 AFFIDAVIT OF LOSS

I, _____________________, Filipino, of legal age, and residing at

_______________________________________, after having been sworn in
accordance with law, hereby depose and state:

1. I am a holder of the Philippine Passport issued by the Department of

Foreign Affairs (DFA) in Manila;

2. The said Philippine Passport was expired;

3. However, sometime in September 2019, the bag where I kept the said
passport was stolen;

4. Despite diligent search, my Philippine Passport is nowhere to be found and

could no longer be recovered/ located; and

5. The undersigned affiant is executing this affidavit to request for the issuance
of a new Philippine Passport, to attest to the truth of the foregoing, and for
whatever legal purpose (s) that this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this __th day of January
2020, in Cavite City, Cavite, Philippines.

___________________
Affiant

SUBSCRIBED AND SWORN to before me on this __th day of January 2020, in

Cavite City, the affiant showing to me his ___________ issued on ____________ at
____________.

NOTARY PUBLIC

Doc. No.____;
Page No.____;
Series of 2020.