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Affidavit of Loss for Pag-IBIG Cash Card

Bhomie D. Trasona filed an affidavit of loss to report that he lost his Pag-ibig Cash Card numbered 603131-0920-6512-36. Despite searching diligently, he was unable to find the lost card and believes it is unrecoverable. He did not have the card confiscated by any government agency. He executed the affidavit to attest to these facts and to request a replacement card.

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Grecean B. Lucasan
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170 views1 page

Affidavit of Loss for Pag-IBIG Cash Card

Bhomie D. Trasona filed an affidavit of loss to report that he lost his Pag-ibig Cash Card numbered 603131-0920-6512-36. Despite searching diligently, he was unable to find the lost card and believes it is unrecoverable. He did not have the card confiscated by any government agency. He executed the affidavit to attest to these facts and to request a replacement card.

Uploaded by

Grecean B. Lucasan
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

REPUBLIC OF THE PHILIPPINES )

CITY OF BACOLOD )
x------------------------------------------------x

AFFIDAVIT OF LOSS

I, BHOMIE D. TRASONA, Filipino, of legal age, married and a resident of


Ceres Phase III, Handumanan Bacolod CIty, Negros Occidental, after being duly
sworn to in accordance with law, hereby depose and state that:

1. I am an employee of Vallacar Transit, Inc., a domestic corporation duly


organized and existing under the laws of the Republic of the Philippines,
with principal office address at Ceres Compound, Purok Himaya, Brgy.
Mansilingan, Bacolod City;

2. I am a registered member of Pag-ibig, and as a member said


government agency issued a Cash Card (Land Bank) with No. 603131-
0920-6512-36 in my favor;

3. I lost my said Cash Card and despite diligent efforts to locate the above-
stated cash card, the same could no longer be found and I believe that
it is beyond recovery;

4. Said cash card was not confiscated by any government agencies


whatsoever; and

5. I am executing this affidavit to attest to the foregoing facts and for the
purpose of securing a replacement, in lieu of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________


at the City of Bacolod, Philippines.

BHOMIE D. TRASONA
Affiant
UMID CRN-0111-4623679-5

SUBSCRIBED AND SWORN TO before me this ___________________, in Bacolod


City. Affiant exhibited his competent evidence of identity stated above.

Doc. No. _________;


Page No. _________;
Book No. _________;
Series of 2018.

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