You are on page 1of 4

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, ALBINA DEMETRIA, of legal age, Filipino, and resident of Block 1


Lot 8, Ignatius St., St. Joseph Subd., Pulanglupa, Las Pinas City, after being
duly sworn to in accordance with law, hereby depose and say that:

1. July 27, 2014, I pawned at B.V. Burgos pawnshop the following:

Date Item Pawnticket No. Amount

4/5/2014 Digital camera 91106-W PHP1,000


6/17/2014 Watch 91531-W PHP300
6/17/2014 1pr earring 91530-W PHP1,700

2. I was issued a pawn tickets by the said pawnshop.

3 However said pawn tickets or pledge certificates inadvertently lost.

4. Inspite of diligent search effort to look for said pawn ticket, all such
effort proved in vain, thus I am now declaring the loss of said pawn tickets.

5. I never sold, alienated conveyed or pledged the said receipt or pawn


tickets or pledge certificate in favor of any person and I hereby release the
said Pawnshop from any liability and hold myself liable should any third
person claim ownership over the said pawned article.

6. I am executing this affidavit to attest to the truth of the foregoing


facts and for all its legal intents, effects, consequences and purposes,
including to redeem or renew said pledge.

ALBINA DEMETRIA
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this September 5,


2014 at Las Pinas City.

Doc. No. 440


Page No. 89
Book No. 86
Series of 2014.

REPUBLIC OF THE PHILIPPINES)


LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, ROY G. RAC, of legal age, Filipino, and resident of Block 1 Lot 30,
Veraville Belcrest, Pamplona 3, Las Pinas City, after being duly sworn to in
accordance with law, hereby depose and say that:

1. July 27, 2014, I pawned at Ochoa Realica pawnshop Urci branch, 2


pcs. wedding ring, 1pc chain, 2pcs necklace w/pendant under
pawnticket no. 2589 in the amount of PHP 28,000, maturity date on
August 28, 2014.

2. I was issued a pawn ticket by the said pawnshop.

3 However said pawn ticket or pledge certificate inadvertently lost.

4. Inspite of diligent search effort to look for said pawn ticket, all such
effort proved in vain, thus I am now declaring the loss of said pawn ticket.

5. I never sold, alienated conveyed or pledged the said receipt or pawn


ticket or pledge certificate in favor of any person and I hereby release the
said Pawnshop from any liability and hold myself liable should any third
person claim ownership over the said pawned article.

6. I am executing this affidavit to attest to the truth of the foregoing


facts and for all its legal intents, effects, consequences and purposes,
including to redeem or renew said pledge.

ROY G. RAC
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this September 2,


2014 at Las Pinas City.

Doc. No. 374


Page No. 76
Book No. 86
Series of 2014.
REPUBLIC OF THE PHILIPPINES)
LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, EVANGELINE LUSPO, of legal age, Filipino, and resident of 113


Filipos St., Centraza Village, Las Pias City, after being duly sworn to in
accordance with law, hereby depose and say that:

1. I am the owner of the bangle (13g 14k) pawned at PAPAS


PAWNSHOP situated at Unit H 47 Real St., Las Pias,

2. On January 18, 2011, I instructed and authorized my cousin ELMER


LUSPO to pawn said item, and was pawned under pawn ticket no. 007669 in
the amount of PHP 4,500.

3. He was issued a pawn ticket by the said pawnshop.

4 However said pawn ticket or pledge certificate inadvertently lost by


me.

5. Inspite of diligent search effort to look for said pawn ticket, all such
effort proved in vain, thus I am now declaring the loss of said pawn ticket.

6. I never sold, alienated conveyed or pledged the said receipt or pawn


ticket or pledge certificate in favor of any person and I hereby release the
said Pawnshop from any liability and hold myself liable should any third
person claim ownership over the said pawned article.

7. I am executing this affidavit to attest to the truth of the foregoing


facts and for all its legal intents, effects, consequences and purposes,
including to redeem or renew said pledge.

EVANGELINE LUSPO
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this December 5, 2011


at Las Pinas.
Doc. No. 439
Page No. 89
Book No. 52
Series of 2011.

You might also like