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Affidavit of Loss: ATM Card

Jisselle Resurreccion executed an affidavit of loss to attest that she lost her Landbank ATM debit card. In the affidavit, she states that (1) she is the owner of the Landbank ATM debit card, (2) she discovered the card was missing from her wallet after returning home from a civic parade, and (3) despite searching, she was unable to find the lost card and believes it is lost beyond recovery. She executed the affidavit to request a replacement card.

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Darlene Baquing
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273 views1 page

Affidavit of Loss: ATM Card

Jisselle Resurreccion executed an affidavit of loss to attest that she lost her Landbank ATM debit card. In the affidavit, she states that (1) she is the owner of the Landbank ATM debit card, (2) she discovered the card was missing from her wallet after returning home from a civic parade, and (3) despite searching, she was unable to find the lost card and believes it is lost beyond recovery. She executed the affidavit to request a replacement card.

Uploaded by

Darlene Baquing
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES )

City/Municipality of _____________) S.S.

AFFIDAVIT OF LOSS

I, JISELLE RESURRECCION, of legal age, single, Filipino, and a resident of Brgy.


#23, San Nicolas, Ilocos Norte, Philippines, after having been sworn in accordance with law,
hereby depose and state that:

1. I am the owner of a VISA ATM DEBIT CARD issued by the LANDBANK OF THE
PHILIPPINES;

2. On February 1, 2020, when I arrived at home from the Civic Military Parade, I discovered
that my LANDBANK ATM DEBIT CARD was no longer in my wallet where I used to
place it;

3. Despite diligent search and efforts to locate my ATM Debit Card, I could not find the same
such that I now believe that the same is lost beyond recovery;

4. Said ATM Debit Card was not confiscated by any officer of the law or any officers of
LANDBANK by reason of any violation of any law, ordinance, presidential decree, or
rules and regulations of said bank; and neither was it offered as collateral for any loan;

5. I am executing this affidavit to attest to the truth of the foregoing facts and to request for a
replacement of my LANDBANK ATM Debit Card.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _______________,


at ___________________, Philippines.

JISELLE RESURRECCION
Affiant

SUBSCRIBED AND SWORN to before me this ___________________, at


___________________, Philippines, affiant exhibiting to me her CAAP ACCESS I.D. No. 373 as
competent proof of her identity.

Doc. No. __________;


Page No. __________;
Book No. __________;
Series of 2020.

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