Scribd Logo
Upload

Welcome to Scribd!

  • Forms Wal in

    Uploaded by

    aja
    6 views3 pages

    Original Title

    Forms Wal In

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views3 pages

    Forms Wal in

    Uploaded by

    aja

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    AFFIDAVIT OF LOSS AFFIDAVIT OF LOSS

    Name: ___________________________________ Name: ___________________________________


    Address: _________________________________ Address: _________________________________
    Thing Loss:_____________ Thing Loss:_____________
    *Please Indicate ID/Account No. If any* *Please Indicate ID/Account No. If any*
    Place of Loss:_____________________________ Place of Loss:_____________________________
    Date of Loss: _____________________________ Date of Loss: _____________________________
    Reason for Loss: __________________________ Reason for Loss: __________________________

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.

    AFFIDAVIT OF LOSS AFFIDAVIT OF LOSS


    Name: ___________________________________ Name: ___________________________________
    Address: _________________________________ Address: _________________________________
    Thing Loss:_____________ Thing Loss:_____________
    *Please Indicate ID/Account No. If any* *Please Indicate ID/Account No. If any*
    Place of Loss:_____________________________ Place of Loss:_____________________________
    Date of Loss: _____________________________ Date of Loss: _____________________________
    Reason for Loss: __________________________ Reason for Loss: __________________________

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.

    AFFIDAVIT OF LOSS AFFIDAVIT OF LOSS


    Name: ___________________________________ Name: ___________________________________
    Address: _________________________________ Address: _________________________________
    Thing Loss:_____________ Thing Loss:_____________
    *Please Indicate ID/Account No. If any* *Please Indicate ID/Account No. If any*
    Place of Loss:_____________________________ Place of Loss:_____________________________
    Date of Loss: _____________________________ Date of Loss: _____________________________
    Reason for Loss: __________________________ Reason for Loss: __________________________

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.

    AFFIDAVIT OF LOSS AFFIDAVIT OF LOSS


    Name: ___________________________________ Name: ___________________________________
    Address: _________________________________ Address: _________________________________
    Thing Loss:_____________ Thing Loss:_____________
    *Please Indicate ID/Account No. If any* *Please Indicate ID/Account No. If any*
    Place of Loss:_____________________________ Place of Loss:_____________________________
    Date of Loss: _____________________________ Date of Loss: _____________________________
    Reason for Loss: __________________________ Reason for Loss: __________________________

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.

    AFFIDAVIT OF LOSS AFFIDAVIT OF LOSS


    Name: ___________________________________ Name: ___________________________________
    Address: _________________________________ Address: _________________________________
    Thing Loss:_____________ Thing Loss:_____________
    *Please Indicate ID/Account No. If any* *Please Indicate ID/Account No. If any*
    Place of Loss:_____________________________ Place of Loss:_____________________________
    Date of Loss: _____________________________ Date of Loss: _____________________________
    Reason for Loss: __________________________ Reason for Loss: __________________________

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.
    AFFIDAVIT OF NO INCOME/ NON-FILING OF AFFIDAVIT OF NO INCOME/ NON-FILING OF
    INCOME TAX RETURN INCOME TAX RETURN
    Name of Affiant:_______________________________ Name of Affiant:_______________________________
    Address: _____________________________________ Address: _____________________________________
    Last Year of Employment: ______________________ Last Year of Employment: ______________________
    Company AND Nature of Work: Company AND Nature of Work:
    _____________________________________________ _____________________________________________
    Name of Child: ________________________________ Name of Child: ________________________________
    Purpose: Purpose:
    _____ College Enrollment BSU _____ College Enrollment BSU
    _____ Scholarship/ Financial Assistance _____ Scholarship/ Financial Assistance
    _____ Tax Exemption _____ Tax Exemption
    _____ Others, Pls Indicate. _____ Others, Pls Indicate.

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.

    AFFIDAVIT OF NO INCOME/ NON-FILING OF AFFIDAVIT OF NO INCOME/ NON-FILING OF


    INCOME TAX RETURN INCOME TAX RETURN
    Name of Affiant:_______________________________ Name of Affiant:_______________________________
    Address: _____________________________________ Address: _____________________________________
    Last Year of Employment: ______________________ Last Year of Employment: ______________________
    Company AND Nature of Work: Company AND Nature of Work:
    _____________________________________________ _____________________________________________
    Name of Child: ________________________________ Name of Child: ________________________________
    Purpose: Purpose:
    _____ College Enrollment BSU _____ College Enrollment BSU
    _____ Scholarship/ Financial Assistance _____ Scholarship/ Financial Assistance
    _____ Tax Exemption _____ Tax Exemption
    _____ Others, Pls Indicate. _____ Others, Pls Indicate.

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.

    AFFIDAVIT OF NO INCOME/ NON-FILING OF AFFIDAVIT OF NO INCOME/ NON-FILING OF


    INCOME TAX RETURN INCOME TAX RETURN
    Name of Affiant:_______________________________ Name of Affiant:_______________________________
    Address: _____________________________________ Address: _____________________________________
    Last Year of Employment: ______________________ Last Year of Employment: ______________________
    Company AND Nature of Work: Company AND Nature of Work:
    _____________________________________________ _____________________________________________
    Name of Child: ________________________________ Name of Child: ________________________________
    Purpose: Purpose:
    _____ College Enrollment BSU _____ College Enrollment BSU
    _____ Scholarship/ Financial Assistance _____ Scholarship/ Financial Assistance
    _____ Tax Exemption _____ Tax Exemption
    _____ Others, Pls Indicate. _____ Others, Pls Indicate.

    Submit VALID Government ID. NO Vaccine Cards. Submit VALID Government ID. NO Vaccine Cards.
    SPECIAL POWER OF ATTORNEY SPECIAL POWER OF ATTORNEY
    Principal:_________________________________ Principal:_________________________________
    Address: _________________________________ Address: _________________________________
    Attorney-in-Fact:__________________________ Attorney-in-Fact:__________________________
    Address:_________________________________ Address:_________________________________
    Purpose: Purpose:
    _____ BIR Transaction *Please Specify: _____ BIR Transaction *Please Specify:

    _____ Land Transfer *Submit Land Title* _____ Land Transfer *Submit Land Title*

    _____ Others *Specify ACTS and Government _____ Others *Specify ACTS and Government
    Agency Concerned* Agency Concerned*

    Submit VALID Government ID of BOTH Submit VALID Government ID of BOTH


    PARTIES. NO Vaccine Cards. PARTIES. NO Vaccine Cards.

    Accomplish signatures of BOTH parties. We DO Accomplish signatures of BOTH parties. We DO


    NOT notarize unsigned SPA. NOT notarize unsigned SPA.

    SPECIAL POWER OF ATTORNEY SPECIAL POWER OF ATTORNEY


    Principal:_________________________________ Principal:_________________________________
    Address: _________________________________ Address: _________________________________
    Attorney-in-Fact:__________________________ Attorney-in-Fact:__________________________
    Address:_________________________________ Address:_________________________________
    Purpose: Purpose:
    _____ BIR Transaction *Please Specify: _____ BIR Transaction *Please Specify:

    _____ Land Transfer *Submit Land Title* _____ Land Transfer *Submit Land Title*

    _____ Others *Specify ACTS and Government _____ Others *Specify ACTS and Government
    Agency Concerned* Agency Concerned*

    Submit VALID Government ID of BOTH Submit VALID Government ID of BOTH


    PARTIES. NO Vaccine Cards. PARTIES. NO Vaccine Cards.

    Accomplish signatures of BOTH parties. We DO Accomplish signatures of BOTH parties. We DO


    NOT notarize unsigned SPA. NOT notarize unsigned SPA.

    You might also like