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Affidavit of Loss by Jackylyn Ybañez

Jackelyn D. Ybañez executed an affidavit stating that (1) she lost her disclosure statement for a household loan from City Savings Bank in Tagum City sometime in April 2018, (2) despite searching, she was unable to find the lost document, and (3) she signed the affidavit to attest to the truth of the loss and inform the proper authorities. The affidavit was sworn on October 30, 2019 in Tagum City, Davao del Norte, Philippines.

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0% found this document useful (0 votes)
29 views1 page

Affidavit of Loss by Jackylyn Ybañez

Jackelyn D. Ybañez executed an affidavit stating that (1) she lost her disclosure statement for a household loan from City Savings Bank in Tagum City sometime in April 2018, (2) despite searching, she was unable to find the lost document, and (3) she signed the affidavit to attest to the truth of the loss and inform the proper authorities. The affidavit was sworn on October 30, 2019 in Tagum City, Davao del Norte, Philippines.

Uploaded by

Alfie Omega
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Republic of the Philippines )

Province of Davao del Norte) Sc.


City of Tagum )
x- - - - - - - - - - - - - - - - - - -x

AFFIDAVIT OF LOSS

I, JACKYLYN D. YBAŇEZ, of legal age, Filipino, single and a resident


of 1438 Ybaňez Compound, Panabo City, Davao del Norte, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and say
that:

I am a bona fide holder of a Disclosure Statement for a Household Loan


with City Savings Bank (CSB) in Tagum City;

Sometime in the month of April 2018, the above-described Disclosure


Statement was misplaced and lost from my possession;

Despite diligent search and efforts, the same could no longer be found
such that I believe that it is now lost beyond recovery;

I execute this affidavit to attest to the truth of the foregoing facts and
to inform the proper authorities concerned regarding such loss.

IN WITNESS WHEREOF, I hereunto affix my signature this 30th day


of October 2019 at Tagum City, Davao del Norte, Philippines.

JACKYLYN D. YBAŇEZ
Affiant

SUBSCRIBED AND SWORN to before me this 30th day of October


2019 at Tagum City, Davao del Norte, Philippines. Affiant exhibited to me her
Department of Education identification card bearing no. 7814360 issued in
Compostela Valley, Philippines.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2019.

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