Affidavit of Loss (Passport)

Republic of the Philippines)

                                     ) S.S.

AFFIDAVIT OF LOSS

(PASSPORT)

I, ___________________, of legal age, Filipino, single and a resident of _______________________________, after having been duly sworn to in accordance with law, depose and state THAT:

1. On January 12, 2010, I was issued a Philippine Passport by the Department of Affairs in Manila;

2. Recently, I had tried to look for the said passport but the same could not be found;

3. Despite diligent search and efforts to locate the said passport, I could not find the same such that I believe that it is now lost beyond recovery; 

4. As such, I am executing this affidavit to attest to the foregoing facts and to support the application for the issuance of a new one in lieu of the one which was lost. 

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in ___________, Metro Manila, Philippines.

_______________

Affiant

SUBSCRIBED AND SWORN to before me this _______ day of __________________ in __________________, Metro Manila, affiant exhibiting to her Government Issued ID No. __________ issued on _____________ at ____________.

Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2017.