PROVINCE OF ________________________ )
CITY OR MUNICIPALITY OF ________________________ )S.S.
AFFIDAVIT OF LOSS
I, ________ , Filipino , of legal age, and residing at ________ , after having been sworn according to law, hereby depose and state that:
1. I am the owner of a school ID with student no. ________ issued by ________ .
2. On or about ________ , I discovered the loss of the said school ID under the following circumstances:
3. Despite diligent efforts, I could not find nor locate the same and I believe that it is truly lost.
4. I am executing this affidavit for whatever legal purpose it may serve and to request for a replacement of said school I.D.
5. 5 522282 22 252 25525 22 252 225222822 82225252822.
8225885 2585858 588558 885285.
SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at CITY OR MUNICIPALITY OF ________________________, ________________________
Affiant, ________ personally appeared before me and exhibited to me Driver's License no. ________ which is valid until ________ .
Doc. No.: _________;
Page No.: _________;
Book No.: _________;
Series of _________.
PROVINCE OF ________________________ )
CITY OR MUNICIPALITY OF ________________________ )S.S.
AFFIDAVIT OF LOSS
I, ________ , Filipino , of legal age, and residing at ________ , after having been sworn according to law, hereby depose and state that:
1. I am the owner of a school ID with student no. ________ issued by ________ .
2. On or about ________ , I discovered the loss of the said school ID under the following circumstances:
3. Despite diligent efforts, I could not find nor locate the same and I believe that it is truly lost.
4. I am executing this affidavit for whatever legal purpose it may serve and to request for a replacement of said school I.D.
5. 5 522282 22 252 25525 22 252 225222822 82225252822.
8225885 2585858 588558 885285.
SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of ______________________, 20______ at CITY OR MUNICIPALITY OF ________________________, ________________________
Affiant, ________ personally appeared before me and exhibited to me Driver's License no. ________ which is valid until ________ .
Doc. No.: _________;
Page No.: _________;
Book No.: _________;
Series of _________.
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