Affidavit Of Loss Of Receipt.docx

REPUBLIC OF THE PHILIPPINES ) Tagum City ) S.S Davao del Norte ) x-------------------------x AFFIDAVIT OF LOSS I, RAUL P. VILLOCINO, Filipino, of legal age, married and a resident of Purok 18, Poblacion , Nabunturan, Compostela Valley Province, Philippines, after having been duly sworn to in accordance with the law, do hereby depose and say; 1. That I am a Special Operation Officer IV located at Poblacion, Nabunturan, Compostela Valley Province; 2. That I was issued an Original Receipt in the sum of Two Thousand Pesos only for Registration Fee; 3. That I was in possession of such Original Receipt from the time of its issuance but the said Original Receipt was lost notwithstanding diligent efforts, the same cannot be recovered or located; 4. That I am executing this Affidavit to attest to the truth and veracity of the foregoing statements and to apprise the proper authorities concerned on the matter for their information, guidance and for whatever legal purpose/s this may serve best. IN WITNESS WHEREOF, I have hereunto set my hand this____ day of __________________ at _________________________, Philippines.

RAUL P. VILLOCINO Affiant I.D No:__________________ SUBSCRIBED AND SWORN to before me this _____ ________________________at ________________________, Philippines. Doc. No. ____; Page No. ____; Book No. ____; Series of ____.

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