Affidavit of Loss SRBD

The affidavit summarizes that: 1) The affiant lost their passport while traveling on a motorcycle. 2) Despite searching, the affiant was unable to find the lost passport. 3) The affiant is executing this affidavit to attest to the truth of the loss and support their application for a new passport.

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Jonna Maye Canindo

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Affidavit of Loss SRBD

Uploaded by

Jonna Maye Canindo

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Republic of the Philippines )

Province of Kalinga ) S.S.

City of Tabuk )

AFFIDAVIT OF LOSS
I, ____________________ of legal age, Filipino Citizens and resident of
__________________________, after having been duly sworn to in accordance with
the law, depose and say:

1. That I am a passport holder with Passport No. _______________ issued by

the Philippine Embassy of ___________________;

2. That I kept the said passport inside my sling bag for safe-keeping;

3. That on _______ at around _, I boarded a

motorcycle from ________________________. However, upon arrival at our
house I noticed that my passport which was placed inside my sling bag
was missing;

4. That despite diligent search and efforts to locate the said passport, I
could not find the same hence, I considered it lost beyond recovery;

5. That I am executing this affidavit of loss to attest the truth of the

foregoing and to support the application for the issuance of new passport
in lieu of the one which was lost.

IN WITNESS WHEREOF, I have hereunto affixed our signature this

__________________________at ___________________________.

________________________
Affiant

SUBSCRIBED AND SWORN to before me this ____________________ at

Tabuk City.

Doc. No.______
Page No.______
Book No.______
Series of 2022.

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Affidavit of Loss SRBD

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Affidavit of Loss SRBD

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Republic of the Philippines )

Province of Kalinga ) S.S.

1. That I am a passport holder with Passport No. _______________ issued by

3. That on _____________________ at around _______________, I boarded a

5. That I am executing this affidavit of loss to attest the truth of the

IN WITNESS WHEREOF, I have hereunto affixed our signature this

SUBSCRIBED AND SWORN to before me this ____________________ at

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3. That on _______ at around _, I boarded a