Nov 14, 2012

Affidavit of Loss of Mayor's Permit or Other Official Document

For those looking for a simple Affidavit of Loss for business documents such as Permit or any other business documentation issued for your company, the sample Affidavit form below may help.

CITY OF/MUN. OF  __________               ))    S.S.


I, ____(insert your name here)__, Filipino, of legal age, married/single and with residence at (insert your business address here), after having been duly sworn in accordance with law, hereby depose and state THAT:

1.      I am the (insert your position) of  (insert your company/corporation’s name here), a corporation duly organized and existing under and by virtue of the laws of the Republic of the Philippines;

2.      That being registered with the BIR/Office of/etc., the (Company name or Corporation)  has been issued a  (insert kind of document lost here) ;

3.      That sometime in (date when permit/official document was lost), the original copy of the said (name of Permit/Official Document) could not be found and that despite diligent search and efforts, the same could no longer be found, such that I believe it is now lost beyond recovery;

4.      As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and for whatever legal purposes that this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ________, 20__ at _____________, Philippines.

                                                              Name of Affiant (signature above written name)


CITY OF __________              ) ) S.S

SUBSCRIBED AND SWORN TO before me this ____ day of (month), 20___ at (City/Municipality), affiant exhibiting to me his valid government-issued identification no. _______________ issued at _________________ and valid until ______________.

                                                                                      Notary Public
                                                                                      Until 31 December 20___
                                                                                      PTR No. __________
                                                                                      Issued at: __________
                                                                                      Issued on: __________
                                                                                      TIN No. ___________

Doc. No. _______
Page No. _______
Book No. _______
Series of ________