Affidavit of Loss Sample and Template Philippines (Free Download)

Losing an important document, ID, or personal belonging can be a stressful and overwhelming experience. In the Philippines, one of the most reliable ways to address this issue legally is by preparing an affidavit of loss. This official document is a sworn statement that details the specifics of what was lost, the circumstances surrounding the loss, and a declaration of good faith by the individual. If you are looking for a detailed affidavit of loss sample and template, this guide will provide all the necessary information, including key components, practical tips, and a free downloadable template.

What Is an Affidavit of Loss?

An affidavit of loss is a legal document that serves as a formal declaration by an individual who has lost a particular item, document, or possession. This document is signed under oath before a notary public and is typically used to:

1. Document loss: Provide an official account of what was lost, including its description and other relevant details.
2. Serve as proof of loss: Institutions, such as banks, government agencies, or insurance companies, often require an affidavit of loss to process replacements or claims.
3. Fulfill legal and administrative requirements: For lost IDs, checks, or other critical items, an affidavit ensures compliance with legal procedures.

When Do You Need an Affidavit of Loss?

You may need an affidavit of loss in several situations, such as:

• Lost Identification Cards: Driver’s license, passport, TIN ID, UMID, SSS ID, or PRC ID.
• Misplaced Official Documents: Property titles, employment contracts, school records, diplomas, certificates, or receipts.
• Banking and Financial Items: Lost checkbooks, passbooks, ATM cards, or credit cards.
• Lost Personal Valuables: Gadgets like laptops or phones, jewelry, or other valuable possessions (especially if required for insurance claims).

For example, if you lose your passport while traveling or misplace your Land Transportation Office (LTO)-issued driver’s license, most agencies will ask for an affidavit of loss before issuing a replacement.

Key Components of an Affidavit of Loss

To ensure your affidavit of loss is legally valid and accepted by institutions, it must include the following key elements:

1. Title: A clear heading, such as “Affidavit of Loss.”
2. Affiant Details: Full name, age, nationality, civil status, and complete residential address of the person making the affidavit.
3. Detailed Description of the Lost Item: Include specific details such as the item’s name, ID or serial number, issuing agency, date of issuance, or other identifiable characteristics.
4. Circumstances of the Loss: Provide a clear and truthful account of when, where, and how the loss occurred.
5. Declaration of Good Faith: State that the affidavit is being executed truthfully and without malice.
6. Date and Location: The date and place where the affidavit is being executed.
7. Affiant’s Signature: The signature of the individual declaring the loss.
8. Notary Public Section: Space for the signature, seal, and stamp of a notary public, which makes the document legally binding

Affidavit of Loss Sample

Below is a detailed sample affidavit of loss:

Republic of the Philippines)
[City/Municipality] …… ) s.s.

AFFIDAVIT OF LOSS

I, [Full Name], of legal age, [Civil Status], [Nationality], and residing at [Complete Address], after having been duly sworn to in accordance with law, hereby depose and state that:

1. I am the lawful owner of the following item/document: [Provide a detailed description of the item/document. For example: “Driver’s License with License Number 123456789, issued on January 1, 2020, by the Land Transportation Office (LTO)”].
2. Sometime on or about [date of loss], while I was at [specific location or circumstance], I discovered that the said item/document was missing. Despite my diligent efforts to locate or recover it, I have been unable to find it and now consider it permanently lost.
3. The circumstances surrounding the loss are as follows: [Provide a clear and concise explanation, e.g., “I was commuting via jeepney along EDSA when I realized that my wallet containing my driver’s license was no longer in my bag.”].
4. I am executing this affidavit to attest to the truth of the foregoing facts and for the purpose of replacing the said item/document or for whatever legal purpose it may serve.
5. I certify under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge and belief.

IN WITNESS WHEREOF, I have hereunto set my hand this [date] at [location], Philippines.

[Signature above printed name]
Affiant

SUBSCRIBED AND SWORN TO before me this [date] at [location], affiant exhibiting to me his/her [Valid ID and details, e.g., “Philippine Passport No. P123456789 issued on January 1, 2025”].

[Signature of Notary Public]
[NAME OF NOTARY PUBLIC]
Notary Public

Doc. No. ____
Page No. ____
Book No. ____
Series of 2025.

How to Prepare an Affidavit of Loss

Here is a step-by-step guide to help you create an affidavit of loss:

1. Gather Information: Collect all the necessary details about the lost item or document, such as serial numbers, issuance dates, and circumstances of loss.
2. Download a Template: Use a ready-made affidavit of loss template (available below) to save time.
3. Fill Out the Affidavit: Provide accurate and truthful details about the loss. Ensure all mandatory fields are completed.
4. Print and Review: Ensure the document is properly formatted and free of errors.
5. Visit a Notary Public: Bring a valid government-issued ID and the completed affidavit to a notary public for notarization.

Free Affidavit of Loss Template

Download our free affidavit of loss template in both Word and PDF formats for your convenience. Simply edit the template to suit your needs, print it, and have it notarized.

Frequently Asked Questions (FAQs)

1. How much does it cost to notarize an affidavit of loss?
The cost of notarizing an affidavit of loss varies by location, ranging from ₱50 to ₱200. Notaries in urban areas may charge higher fees.

2. Is an affidavit of loss required for a lost passport?
Yes, the Department of Foreign Affairs (DFA) requires an affidavit of loss to process a replacement for a lost passport.

3. Can I create an affidavit of loss myself?
Yes, you can create one yourself using a template, but it must be notarized to be considered legally valid.

4. What happens if I find the lost item after submitting an affidavit?
Inform the concerned agency or institution immediately to update your records and avoid potential legal complications.

Conclusion

An affidavit of loss is an essential document when dealing with the loss of valuable items or documents in the Philippines. By using the comprehensive guidelines and sample provided in this article, you can create a legally valid affidavit to fulfill any administrative or legal requirement. Ensure your affidavit is notarized to make it binding and accepted by institutions. For added convenience, don’t forget to download our free affidavit of loss template today.

Bookmark this guide for future reference, and share it with anyone who might need assistance in preparing their affidavit of loss.

Disclaimer: This article is for informational purposes only and does not constitute legal advice. While every effort has been made to ensure the accuracy of the information provided, readers are advised to consult a qualified attorney or legal professional for guidance specific to their situation. The templates and samples included are general examples and may need to be tailored to comply with specific legal requirements in your jurisdiction.

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