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    Affidavit of Loss of UMID Card

    Uploaded by

    Werner Schlager
    Jon Snow files an affidavit of loss stating that he lost his temporary Government Service Insurance System identification card. In the affidavit, he details that he usually kept the card in his pouch, but discovered it was missing after work on August 21, 2016. Despite searching, he was unable to find the lost card. He executes the affidavit to comply with GSIS requirements to reconstitute the lost document. The affidavit is notarized.

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    Affidavit of Loss of UMID Card

    Uploaded by

    Werner Schlager
    517 views2 pages
    Jon Snow files an affidavit of loss stating that he lost his temporary Government Service Insurance System identification card. In the affidavit, he details that he usually kept the card in his pouch, but discovered it was missing after work on August 21, 2016. Despite searching, he was unable to find the lost card. He executes the affidavit to comply with GSIS requirements to reconstitute the lost document. The affidavit is notarized.

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    Affidavit of loss of UMID Card.doc

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    Jon Snow files an affidavit of loss stating that he lost his temporary Government Service Insurance System identification card. In the affidavit, he details that he usually kept the card in his pouch, but discovered it was missing after work on August 21, 2016. Despite searching, he was unable to find the lost card. He executes the affidavit to comply with GSIS requirements to reconstitute the lost document. The affidavit is notarized.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    517 views2 pages

    Affidavit of Loss of UMID Card

    Uploaded by

    Werner Schlager
    Jon Snow files an affidavit of loss stating that he lost his temporary Government Service Insurance System identification card. In the affidavit, he details that he usually kept the card in his pouch, but discovered it was missing after work on August 21, 2016. Despite searching, he was unable to find the lost card. He executes the affidavit to comply with GSIS requirements to reconstitute the lost document. The affidavit is notarized.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    REPUBLIC OF THE PHILIPPINES)

    _____________________________) SS.

    AFFIDAVIT OF LOSS

    I, JON SNOW, Filipino, of legal age, and a resident of Planet of the Apes,
    after having been duly sworn in accordance with law, hereby depose and say:

    1. That I am a holder of a temporary Unified Multi-Purpose Identification Card


    issued by the Government Service Insurance System or GSIS;

    2. That I used to put said temporary UMID Card in my pouch;

    3. That sometime on August 21, 2016, when I arrived home from work, I
    discovered that my temporary UMID card was no longer in my pouch where I
    used to place it;

    4. Despite diligent search and efforts to locate said document, I could not
    find it.

    5. That said temporary UMID Card was not confiscated by the authorities of
    company by reason of any violation of company rules and regulations;

    6. I am executing this affidavit to comply with the requirements of the GSIS


    for the reconstitution of said document.

    IN WITNESS WHEREOF, I have hereunto affixed my signature this ____day


    of ____________ 20___ at ____________, Philippines.

    ROWENA P. VINEGAS

    SUBSCRIBED AND SWORN TO before me, a notary public in and for


    _____________________ this ____ day of ____________ 20___. The affiant, whom I
    identified through the following competent evidence of identity:
    _____________, valid from______ to______ issued by_______________, personally
    signed the foregoing instrument before me and avowed under penalty of law
    to the whole truth of the contents of said instrument.

    Notary Public
    Doc. No. ........;
    Page No. .......;
    Book No. .......;
    Series of 2011.

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