September
10, 2018
AFFIDAVIT OF LOSS
TO WHOM IT MAY
CONCERN:
That I, ALONA D. CADAG, a resident
of Blk. 7, Lot 5, Rafeli St., Chateau Ville Subd., likewise of legal age,
married, after having sworn to in accordance with law do hereby depose and say;
That I am the absolute owner of the
following motor vehicle by virtue of Deed of Sale duly notarized dated
September 7, 2018 more particularly described as follows:
MAKE/TYPE : NISSAN
URVAN/VAN
MODEL : 2005
ENGINE NO. : TD2Y-753945
CHASSIS NO. : TVP4LEFE24-A28874
PLATE NO. : XTX-379
That the following documents were
lost inside the motor vehicle were I am
riding on way to Makati sometime on September 10, 2018;
1. Orig.
CR/OR of the motor vehicle duly registered in favor of NOTRE DAME DE VIE
INSTITUTE of Bo. San Agustin Novaliches Proper Q.C.
2. Orig.
Deed of Sale duly notarized from NOTRE DAME DE VIE INSTITUTE (VENDOR) with Secretariat
Certificate to JEORGE A. LEONARDO (VENDEE) dated September 6, 2011.
3. Orig.
Deed of Sale duly notarized from GEORGE A. LEONARDO (VENDOR) to ALONA D. CADAG
(VENDEE) dated September 7, 2018.
4. Orig.
Highway Patrol Clearance Transfer of Ownership dated September 7, 2018.
5. Orig.
copy of TPL insurance for LTO copy dated September 7, 2018.
6. Orig.
copy of Emission Test accredited by Manila West LTO District Office.
7. Photo
copy of Identification Card of the following:
a. NOTRE
DAME DE VIE INSTITUTE
b. GEORGE
A. LEONARDO
c. ALONA
D. CADAG
That
the above cited documents were placed in tact in an envelope placed besides me on
board the vehicle bound for Makati. When I alighted the vehicle I forgot to
bring my envelope.
That
I exerted much effort to locate and find the vehicle, I was able to traced the
vehicle but my envelope has gone already missing.
That
I executed this affidavit to attest the truth of the foregoing instrument.
ALONA
D. CADAG
Affiant
SIGNED IN THE
PRESENCE OF
___________________________ ___________________________
REPUBLIC OF
THE PHILIPPINES )
PROVINCE OF
_______________________: S.S.
CITY/MUNICIPALITY_________________)
Before me Notary Public for and the
City/Municipality of ___________________ appeared with Res. Cert. No.
_______________ issued on _________________ at _______________________ known to
me as the same person who executed the foregoing instrument.
WITNESS MY HAND AND SEAL this ______
day of ______________ 2018.
Doc. No.
______
Page No.
______
Book No.______
Series of ______
REPUBLIC OF THE PHILIPPINES )
CITY OF TANAUAN : S.S.
PROVINCE
OF BATANGAS )
AFFIDAVIT
OF LOSS
That I, ANICETO A. MENDOZA, of legal
age, Filipino citizen and a resident of Brgy. Banga, Talisay, Batangas, after
having been sworn to in accordance with law, hereby depose and say:
- That while on February 23, 2018, when I was on Talisay, Batangas with my owner type jeep, I parked near at the Talisay Gymnasium and I inadvertently lost my handbag with my Pistol Colt 45 with serial no. 1877884, and other important documents;
- That efforts to locate the same proved futile;
That I am executing this affidavit to attest to the truth of the
foregoing and for all legal intents and purposes this may serve.
Affiant
sayeth naught
ANICETO
A. MENDOZA
Affiant
SUBSCRIBED AND SWORN to before me,
this ____ day of ____________, 2018, affiant having exhibited his Community Tax
Certificate No. 29715078, issued at Talisay, Batangas on January 26, 2018.
WITNESS
MY HAND AND SEAL.
Doc. No. _______
Page No. _______
Book No. _______
Series of 2018.
Note: All of information's like name, address and other sensitive information are not true and this is for example purposes only.