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Affidavit of Loss (Or CR)

Crisanto A. Pabellan filed an affidavit of loss stating that: 1. He is the registered owner of a Honda sedan with plate number LDR 888. 2. He noticed last month that the original copy of the official receipt and certificate of registration for the vehicle was missing. Despite searching, he was unable to find the documents. 3. He did not transfer or encumber the documents to any person, entity, or financial institution. 4. The documents were not confiscated by any government authorities. He executed the affidavit to attest to losing the documents and for any legal purpose.

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Kaiser Delos Cientos Narciso
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12K views2 pages

Affidavit of Loss (Or CR)

Crisanto A. Pabellan filed an affidavit of loss stating that: 1. He is the registered owner of a Honda sedan with plate number LDR 888. 2. He noticed last month that the original copy of the official receipt and certificate of registration for the vehicle was missing. Despite searching, he was unable to find the documents. 3. He did not transfer or encumber the documents to any person, entity, or financial institution. 4. The documents were not confiscated by any government authorities. He executed the affidavit to attest to losing the documents and for any legal purpose.

Uploaded by

Kaiser Delos Cientos Narciso
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES)

C I T Y O F D A V A O - - - - ) SS.
AFFIDAVIT OF LOSS
I, CRISANTO A. PABELLAN, of legal age, married and with
address at Phase 2, SI.I.R. New Matina, Davao City, after being duly
sworn, hereby depose and say that:
1.
I am the registered owner of a motor vehicle, specifically
described as follows:
Make: Honda
Denomination: Car Light
Body Type: Sedan

Engine No. :P6DD1-P300900


Chassis: PADEK3520WV000907
Plate No. LDR 888

2.
Sometime last month, I noticed that the original copy of
the Official Receipt (OR) and Certificate of Registration (CR) of the
aforesaid motor vehicle was missing among my files. I exerted diligent
efforts to locate the same but all my efforts were in vain. Thus, I
consider the said OR/CR to have been lost and beyond recovery;
3. Said documents were neither transferred to other
persons/entity/financial institutions
for
any
consideration
nor
encumbered to guarantee financial obligations with any financial
institution;
4.
Said
documents
were
not
confiscated
by
any government authorities for violation of R.A. 4136 and other related
laws;
5.
I shall assume responsibility or liability if in any event I will
use these documents for whatever illicit transaction; and
6.
I am executing this affidavit to attest to the truthfulness of
the foregoing narration of facts and for whatever legal purpose this
may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this
__________________ at Davao City, Philippines.

CRISANTO A. PABELLAN
Affiant

SUBSCRIBED AND SWORN to before me this ____________________,


at Davao City, Philippines, affiant
exhibiting to me his
as his
competent evidence of identity.

Doc. No. ____;


Page No. ____;
Book No ____;
Series of 2016.

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