Você está na página 1de 1

REPUBLIC OF THE PHILIPPINES )

Las Piñas City ) ss.

AFFIDAVIT OF LOSS

I, MARC KEVIN E. DITONA, of legal age, Filipino, single a


resident of No 92 Lalaine Bennet St., BF Resort Village, Las Piñas
City, under oath declare that:

1. I am the brother of Paulina Marie E. Ditona, who is the


registered owner of a Chevrolet, Colorado 2013 motor vehicle
with plate no. UNA68 and chassis no. MMM148MH0DH617054.
2. My above-named sister has given me authority to execute the
foregoing Affidavit of Loss.
3. On June 24, 2018, while the subject motor vehicle was parked
in front of my house when I noticed that the plate number and
the vanity plate number PSALM91 were missing.
4. I took pains to look for the plate number and vanity plate
number but to no avail.
5. Despite diligent search and efforts to locate the said plate
number and vanity plate number, I could not find the same and
is now considered as lost and beyond recovery.
6. I am executing this Affidavit of Loss to attest to the truthfulness
and veracity of the foregoing statements; and to be issued a
replacement of the lost plate number in lieu of the one that was
lost.

I have affixed my signature on this 25th day of June 2018 in Las


Piñas City.

MARC KEVIN E. DITONA


Affiant

SUBSCRIBED AND SWORN to before me on this 25th day of


June 2018 with affiant exhibiting to me his Driver’s License No.
N2610016739 issued at Land Transportation Office, until May 15,
2019.
Witness my hand and seal.
NOTARY PUBLIC
Doc. No.
Page No.
Book No.
Series of 2018.

Você também pode gostar