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Affidavit of Non Receipt of Policy

This affidavit details that the affiant applied for a life insurance policy from Paramount Life & General Insurance Corporation in 2004 that was approved, but the affiant never received a physical copy of the policy. The affiant has been paying premiums through salary deductions since 2004 but still has no copy of the policy. The affiant executed this affidavit to attest to these facts.

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Sig G. Mi
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1K views

Affidavit of Non Receipt of Policy

This affidavit details that the affiant applied for a life insurance policy from Paramount Life & General Insurance Corporation in 2004 that was approved, but the affiant never received a physical copy of the policy. The affiant has been paying premiums through salary deductions since 2004 but still has no copy of the policy. The affiant executed this affidavit to attest to these facts.

Uploaded by

Sig G. Mi
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 )

City of Davao ) s.s.


x--------------------------------------/

AFFIDAVIT OF NON-RECEIPT OF POLICY

I, ____________________, of legal age, married, a Filipino and a resident


___________________________, Davao City, after having been duly sworn to in
accordance with law, do hereby depose and state THAT:

1. I am a life insurance policy holder of PARAMOUNT LIFE & GENERAL LIFE


INSURANCE CORPORATION;

2. I applied for a life insurance policy from PARAMOUNT LIFE & GENERAL INSURANCE
CORPORATION on 2004 and the application was likewise approved in the same year;

3. As such, a life insurance policy was issued in my favor bearing policy no.
______________;

4. However, I have never received a physical copy of the said life insurance policy and that
I have only been informed of the Policy Number mentioned above;

5. I have been paying insurance premiums every fifteenth (15th) and thirtieth (30th) day of
the month in the amount of One Thousand One Hundred Twenty Four Pesos (Php
1,124.00) through a salary deduction from the time I was issued the policy up to the
present;

6. To date, I have no copy hard copy or physical copy of my life insurance policy;

7. I am executing this Affidavit in order to attest to the truth of the foregoing facts and for
whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto set my hand this March 2, 2018 in Davao
City Philippines.

_________________________
Affiant

SUBSCRIBED AND SWORN TO before me this March 2, 2018 in Davao City,


Philippines, affiant exhibiting her Social Security System Identification Card bearing ID No.
_________________________.

Doc. No.: ______ Notary Public


Page No.: ______
Book No. ______
Series of 2018

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