REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
1. That I am a holder of Automated Teller Machine (ATM) Card No. 0000000000 duly issued in my favor by Bank of Philippine Islands, on (Date) in Quezon City;
2. That I used to put said ATM card in my wallet;
3. That sometime on January 5, 2022, when I arrived home from work, I discovered that said ATM card was no longer in my wallet;
4. That diligent effort to locate the same proved futile;
5. That in view thereof, I now desire and hereby request BDO to issue another ATM card in lieu of the lost one;
6. That I bind myself to save BDO harmless from any loss or damage that it may incur in connection with the issuance of a new ATM card in lieu of the lost one;
7. That I am executing this affidavit to attest to the foregoing facts and for any legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification (ID Number) issued on (Date) in (Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
That I am the true owner of _______________, described as follows to wit: (Description of property)
That the said automobile had been duly registered in my name in the Land Transportation Office in ___________ for the year (or years) ____________;
That the certificate of registration and other pertinent papers of ownership of said automobile were among those flooded and destroyed on ____________ when my house and all my personal belongings were completely destroyed by storm and flood;
That said papers are now beyond recovery.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification(ID Number) issued on (Date) in(Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
1. That I desire to avail of the free legal service of the Public Attorney’s Office.
2. That my monthly net salary/income is P____________.
3. That I am executing this affidavit to entitle me to the desired legal services.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification(ID Number) issued on (Date) in(Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
1. I am the same person who executed the long form signature appearing on my (Description of Identification Card or Document) under the name (Name of Affiant), and who executed the short form signature appearing on some official documents including those appearing on (Description of Documents where the different signature appears).
2. Both long and short form signatures as they appear in said official documents are therefore executed by one and the same person, the undersigned affiant, as I used the long form and at other times used the short form when I signed official documents, exercised my employment and transact with offices or agencies.
3. I agree to indemnify and hold (Name of Agency or Institution) and their respective officers, employees, and agents harmless from and against any liability incurred by said agency/institution for relying in good faith upon the declaration provided in this affidavit.
4. I am executing this affidavit to attest to the truth of the foregoing facts and to explain the difference in my signatures.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification (ID Number) issued on (Date) in (Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.
REPUBLIC OF THE PHILIPPINES)
) S.S.
I, (Name), of legal age, Filipino, married and a resident of (Address), after having been duly sworn to in accordance with law, depose and state:
1. That I am the Aunt and guardian of (Name of Minor), a minor, born on (Date of Birth of Minor), being the sister of his late mother (Mother of Minor);
2. That the above mentioned minor is under my care and custody;
3. That I am competent to receive in behalf of the said minor any amounts due her from the Social Security System, insurance firms, and other financial institutions; and
4. That I am not a vagrant, vicious, imbecile, or insane person, or a habitual drunkard or a habitual criminal, and I have not abandoned, neglected or refused to support said minor or caused her to commit offenses against the law;
5. That I am executing this affidavit to attest to the truth of all the foregoing statements and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this (Date) in (Place), Philippines.
(Name)Affiant
SUBCRIBED AND SWORN TO before me this (Date) in (Place), Philippines by (Name of Affiant) affiant exhibiting to me his Competent Evidence of Identity by way of Passport Identification(ID Number) issued on (Date) in(Place).
Notary Public
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 20__.