Professional Documents
Culture Documents
AFFIDAVIT OF LOSS
(RE: RAFFLE TICKET)
1. That sometime in December 2020, I was given a Raffle Ticket with ticket No.
245653 upon payment of purchased product of Aldiz Incorporated for their
product promos;
3. That however, just recently, when I am in need of said Raffle Ticket, I noticed
that the same is already missing;
4. That despite my earnest and diligent effort to locate said Raffle Ticket, it proved
futile and thus, said Raffle Ticket is now given up as lost;
6. That I am executing this affidavit to attest that the said Raffle Ticket was lost
and for all legal intent and purposes that it may serve.
SUBSCRIBED and SWORN TO ME before this 25 th day March, 2021, at Bambang, Nueva
Vizcaya, affiant personally known to me to be the same person who executed the
foregoing affidavit.
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF NUEVA VIZCAYA )S.S.
MUNICIPALITY OF BAYOMBONG)
AFFIDAVIT OF LOSS
(RE: VACCINATION CARD)
1. That sometimes on October 21, 2021, I was issued a COVID-19 Vaccination Card
with ID No. 409-2D2 by the LGU of Bambang, Nueva Vizcaya;
4. That despite my earnest and diligent effort to locate said vaccination card, it
proved futile and thus, said vaccination card is now given up as lost;
6. That I am executing this affidavit to attest that the said vaccination card was lost
and for all legal intent and purposes that it may serve.
AFFIDAVIT OF LOSS
(RE: DTI Certificate)
1. That I am the owner of the business name DAWAN RICE MILL which is
registered with the Department of Trade and Industry (DTI) pursuant to the
provisions of Act 3883, as amended by Act 4147 and RA 863;
3. That recently, when I was in need of it, I noticed that the same is already
missing;
4. That despite my earnest and diligent effort to locate said certificate, it proved
futile and thus, said certificate is now given up as lost;
6. That I am executing this affidavit to attest that the said certificate was lost and
for all legal intent and purposes that it may serve.
VENIRANDO T. DAWAN
Affiant
CEI: UMID CRN-0113-0049047-4