Philippines - Affidavit Of Loss

AFFIDAVIT OF LOSS

I, _________________________________, of legal age, Filipino, ____________ (civil status) and presently residing at ________________________________________, after having been sworn to in accordance with law, hereby depose and say: That I was born on ___________________in __________________________________; That I arrived in Switzerland on _____________________________________as ____________________________________(purpose); That I was issued passport number __________ on _____________________ in __________________________; That said passport was lost (please state when, where and how it was lost)

That I reported the matter to the police authorities in _____________________________ on _______________________________; (OR) That I did not report the matter to police authorities because _________________________________________________________________________; and That I am executing this affidavit to request the Philippine Consulate General in Geneva to issue me a new passport. IN WITNESS WHEREOF, I hereunto affix my signature this ________________ 20___, at Geneva, Switzerland

_________________________ Affiant

THE PHILIPPINE CONSULATE GENERAL GENEVA, SWITZERLAND

) ) S.S.

SUBSCRIBED AND SWORN TO before me this ____________________20__ in Geneva, Switzerland. Book No. Doc. No. Page No. Date Fee O.R. No.

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