Affidavit of Loss Plate Number

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Republic 

of the Philippines )
City of Roxas )s.s.
x------------------x

AFFIDAVIT OF LOSS

I, SANDRA CUÑADA y PATRICIO, Filipino, of legal age, married, and a


resident of Barangay Casanayan, Pilar, Capiz, Philippines, after being duly sworn
in accordance with law, depose and state:

1. That on July 13, 2017 at around 11:30 o’clock in the morning I was driving
our motor vehicle registered in my husband’s name, EMMANUEL
CUÑADA more particularly described as follows:

Make: CHEVROLET PICK- UP (Metallic Brown)


Plate No.: WQJ 944
Chassis No.: MMM148ELOEH604662
Motor No.: BGTG132471063

2. That on the said date and time I traversed the National Highway from
Poblacion, Pilar to our home in Casanayan, Pilar. However, upon reaching
thereat, I noticed that the plate number attached at the front bumper is
missing;

3. That despite diligent search and efforts to locate the said license plate, it
could not be found and such the same that I now believe that they are now
lost beyond recovery.

4. As such, I am executing this Affidavit of Loss to attest to the truth of the


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

IN WITNESS WHEREOF, I have hereunto set my hand this


______________ at Roxas City, Philippines.

SANDRA P. CUÑADA
Affiant

SUBSCRIBED AND SWORN to me this _________________ in the City


of Roxas, Capiz, Philippines.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy