AFFIDAVIT OF LOSS

I, [Your Name], of legal age, Filipino citizen, and resident of [Your Address], Philippines, after being duly sworn in accordance with law, hereby depose and state under oath:

1. That I am the lawful owner/holder of the following lost item/document: [Specify the lost item/document, such as identification card, passport, driver's license, etc.].

2. That the lost item/document was in my possession and custody, and I have exercised due care and diligence to keep it safe and secure.

3. That I have made a diligent search and inquiry to locate the lost item/document but to no avail. It is irretrievably lost and cannot be recovered.

4. That the loss of the said item/document was not due to any negligence, willful act, or omission on my part.

5. That I am executing this Affidavit of Loss to attest to the truth of the foregoing facts and for the purpose of applying for the issuance of a new/replacement item/document.

IN WITNESS WHEREOF, I have hereunto set my hand this [day] of [month], [year], in [City/Municipality], Philippines.

________________________

[Your Name]

SUBSCRIBED AND SWORN to before me this [day] of [month], [year], in [City/Municipality], Philippines, affiant exhibiting competent evidence of identity through [type of identification card] with ID number [ID number], issued on [date of issuance].

WITNESS MY HAND AND SEAL.

Notary Public

Doc. No. _____;
Page No. _____;
Book No. _____;
Series of [Year].