I, (Name of Affiant)., Filipino, of legal age, residing at (Address of Affiant), after having been sworn in accordance with law hereby depose and state:
That I am the true and lawful owner of a certain motor vehicle which is more particularly described as follows:
(Remove the table above if the item lost is not a vehicle certificate of registration & change the declaration below to suit your actual circumstances.)
That sometime in June of this year, I was looking for the original Certificate of Registration of my car but to my surprise, said Owner�s original Copy could not found;
That I took pains to look for said Certificate of Registration, but to no avail;
That I am executing this affidavit to attest to the truth of the foregoing and to request from the Land Transportation Office of Angeles City, a copy of said Certificate of Registration.
IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of _______________. 20___ at _________________________.
_____________________________
(Name Over Signature of Affiant)
SUBSCRIBED AND SWORN to before me, this ____ day of ______________, 20___ in ___________________ City, with affiant exhibiting his CTC No. _______________ ,
Issued on ______________________ at _________________________.
NOTARY PUBLIC
Until December 31, 20___
Doc. No. : ________;
Page No. : ________;
Book No. : ________;
Series of 20_______.
Sample of Affidavit of Loss of Vehicle Registration:
This Sample Affidavit of Loss of Cell Phone/SIM Card may be Revised indicate Loss of any item e.g. Wallet, Credit Card, Driver's License, ID, Money, Bag, etc.
