Professional Documents
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AFFIDAVIT OF LOSS
I, LOPEZ Y TEOFILO DIENTE JR, of legal age, Filipino, married and a resident of Purok
Katilingban,Bagumbayan, Sultan Kudarat, after having been duly sworn to in accordance with law do
hereby depose and say:
MAKE/TYPE OF BODY--------------------KAWASAKI/MC
Serial/Chassis No: -----------------------------DUZWCJ33998
Engine No: --------------------------------------MD2A18AZ6CJ35895
PLATE NO. ------------------------------------XZ1377
COLOR: ----------------------------------------BLACK
2. That sometime on November 20, 2017 I discovered that said Identification Cards were lost
or misplaced by me;
3. That I diligently searched and look for the said Identification cards but I could no longer
locate the same;
4. That I execute this affidavit to establish and declare the fact of the foregoing statements and
for whatever purpose this affidavit may serve best.
IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of November, 2017 at Isulan,
Sultan Kudarat, Philippines.
SUBSCRIBED AND SWORN to before me this 23rd day of November, 2017 at Isulan, Sultan
Kudarat, Philippines.