Affidavit of Loss

Republic of the Philippines)                                       

______________________      ) Sc.

AFFIDAVIT OF LOSS 

 I,      ______________________, Filipino, of legal age, married, and with residence and postal address at ________________________________________________________________, after having been duly sworn to in accordance with law, hereby depose and state that:

1.         I have been trying to look for the original Certificate of Registration of my car with the following details:

MAKE                    :	MOTOR NO.                      :
SERIES                  :	SERIAL/CHASSIS NO.      :
TYPE OF BODY      :	PLATE NO.                        :
YEAR MODEL        :	FILE NO.                           :
	C.R. NO.                            :

2.         Diligent efforts to locate the said document were exerted but it proved futile; and

3.         I am executing this affidavit to attest to the truthfulness of the foregoing facts and for the purposes of declaring it loss and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ____________________ at __________________, Philippines.

AFFIANT FURTHER SAYETH NAUGHT.

                                                

______________

               Affiant                       

                                                

JURAT

SUBSCRIBED AND SWORN to before me this _____ day of ____________________________ affiant personally appeared and exhibited to me his Government-issued Identification Card No. ________________________, issued on _____________________ at City of Makati.

NOTARY PUBLIC

Doc.  No.: _____;

Page No.: _____;

Book No.: _____;

Series of 2019.