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Affidavit of Loss

For a lost ID, passport, card, licence or document. Fill it in, print it, and sign it in front of the notary.

You

In years, for example 34.

What Was Lost

For example, No. N01-23-456789, issued by LTO.

For example, 3 October 2026.

Finish the phrase "I believe it was lost…". For example, at SM City Lipa, or inside a jeepney along Ayala Avenue.

One or two sentences, in the first person.

For example, the replacement of my Driver's License.

Where

ID

For example, Philippine passport No. P1234567A, or PhilSys ID No. 1234-5678-9012-3456.

What you type is kept on this device only, so you can come back and finish later. Nothing is sent anywhere. Press Clear to erase it, especially on a shared phone or computer.

REPUBLIC OF THE PHILIPPINES )
city or municipality ) S.S.

AFFIDAVIT OF LOSS

I, full name, age years old, Filipino, civil status, and residing at home address, after having been duly sworn in accordance with law, hereby depose and state that:

  1. I am the owner and holder of the following: what was lost, number or details;
  2. On or about date, I discovered that it was missing. how it was lost
  3. Despite diligent efforts to find it, I have not been able to recover it;
  4. It has not been sold, pledged or given to anyone, and I have not used it for any unlawful purpose since it was lost;
  5. I am executing this affidavit to attest to the truth of the foregoing and to support purpose, and for whatever other lawful purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of ______________ 20___ at city or municipality, Philippines.

full name
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of ______________ 20___ at city or municipality, Philippines, affiant exhibiting to me ID type and number as competent evidence of identity.

Doc. No. ______;
Page No. ______;
Book No. ______;
Series of 20___.

NOTARY PUBLIC

Before You Print

  • Not legal advice. This is a general form. For your own situation, consult a lawyer, especially if your case is unusual or a lot of money is involved.
  • You will swear before the notary that it is true, then sign (this is called a jurat).
  • Do not sign it yet. You sign in front of the notary, with a valid government ID.

What notarizing it usually costs →

For the steps around this document, see the guide Affidavit of Loss.

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