Affidavit Of Loss - Foreign Service Of The Philippines printable pdf download

Affidavit Of Loss - Foreign Service Of The Philippines

FOREIGN SERVICE OF THE PHILIPPINES)

EMBASSY OF THE PHILIPPINES

) S. S.

CONSULAR SECTION, KUALA LUMPUR )

AFFIDAVIT OF LOSS

I, ____________________________________________ of legal age, Filipino

citizen,

married/single

with

residence

and

postal

address

______________________________________________________________________

After having been sworn to in accordance with law, do hereby depose and state the

following:

That I am a holder of Philippine Passport No. _____________________ issued

on ___________________ 20____ by the ___________________________________

in ______________________________________ ;

That the circumstances surrounding the loss of my passport follows:

------------------------------------------------------------------------------------------------------------

That I execute this affidavit for the purpose of giving true and correct statement

surrounding the loss of my passport;

That further affiant sayeth naught.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ______ Day

of ________________ 20___ at the Philippine Embassy in Kuala Lumpur, Malaysia

__________________________

(Affiant)

SUBSCRIBED AND SWORN to before me this ____________ day of ______________

20___ in Kuala Lumpur, Affiant exhibiting to me photocopy of his/her Passport

No. _______________ issued on _____________________ 20 ____ at ____________

_________________________________.

____________________

Consular Officer

Affidavit Of Loss - Foreign Service Of The Philippines