Affidavit of Loss
Affidavit of Loss
AFFIDAVIT OF LOSS
I, JUAN DELA CRUZ, of legal age, single, and a resident of Espana, Manila, after having been
sworn to in accordance with law hereby depose and say:
1. That I am the owner of a NOKIA N90 CELLULAR PHONE with serial number IMEI789887-7898-
74 and unit number 0922-3179003 under account number 9807865643;
2. That on the 28th of January, 2007 with a number of things I was carrying while getting out of my
car, said cell phone must have slipped from my pocket because after I reached my office, I
hurriedly tried to get my said cell phone from my pocket but I was surprised that it was not there
anymore;
3. That after diligent search inside my car and office as well as the elevator I used going upto my
office, said cell phone was nowhere to be found anymore;
4. That I am executing this affidavit in order to attest to the truth of the foregoingcircumstances and
for the purpose of reporting the loss to the Globe Business Center.
IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of January, 2006 in the Cityof
Manila, Philippines.
JURAT
SUBSCRIBED AND SWORN to before me, this __th day of March, 2007 in the City of Manila, affiant
exhibiting before me his Community Tax Certificate No. 123456, issued at Manila on March 1, 2007
I, JUANA DELA CRUZ, of legal age, married to JUAN DELA CRUZ, Filipino Citizen and a resident of 25 –
I West Drive, Marikina, hereinafter known as the VENDOR;
and
JOSE SANTOS, of legal age, single, Filipino Citizen and a resident of Unit 23-A, Starlight Condominium,
Ortigas Center, Pasig City, hereinafter known as the VENDEE;
WITNESSETH:
1. That the VENDOR is the absolute owner of a residential lot in Sucat, Paranaque with an area of120
square meters covered by Transfer Certificate of Title No. 123456, Registry of Deeds of Paranaque;
2. That for and in consideration of the sum of NINE THOUSAND FIVE HUNDRED PESOS(P9,500.00)
per square meter or a total of ONE MILLION ONE HUNDRED FORTY THOUSANDPESOS
(P1,140,000.00), receipt of which is hereby acknowledge, VENDOR hereby SELL,TRANSFER and
CONVEY to the VENDEE, his heirs, assigns and transferees, the aforesaid described parcel of land
together with all improvements thereon, free from all liens and encumbrances;
3. That the VENDEE undertake to pay all taxes, registration and transfer fees as well as the village
association dues.
IN WITNESS WHEREOF, we hereunto sign this deed of absolute sale in Manila, Philippines onthis 25th
day of February, 2006.
Vendor Vendee
Witnesses:
MR. A MR. B
ACKNOWLEDGMENT
BEFORE ME, this 16th day of February, 2007 in the Municipality of Taal, Province of Batangas,
Philippines, personally appeared PEDRO SANTOS, with Residence Certificate No. 123456 issued at
Taal, Batangas, on February 1, 2007, and Taxpayer’s Identification No. 456789 known to me and to me
known to be the same person who executed the foregoing instrument and he acknowledged to me that
the same is his free act and deed. This instrument, consisting of 5 pages, including the page on which
this acknowledgment is written, has been signed on the left margin of each and every page thereof by
PEDRO SANTOS and his witnesses, and sealed with my notarial seal.
IN WITNESS WHEREOF, I have hereunto set my hand, the day, year, and place above written.