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Philhealth and Unified Multi-Purpose ID: Affidavit of Loss

The affidavit details the loss of a Philhealth Identification Card and Unified Multi-Purpose ID card. The affidavit states that the cards were kept in the affiant's wallet which slipped out of their pocket while traveling from work. Despite searching, the cards were not found. The affidavit is being made to justify issuing replacement cards.

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Alexandra Castañeda
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75 views1 page

Philhealth and Unified Multi-Purpose ID: Affidavit of Loss

The affidavit details the loss of a Philhealth Identification Card and Unified Multi-Purpose ID card. The affidavit states that the cards were kept in the affiant's wallet which slipped out of their pocket while traveling from work. Despite searching, the cards were not found. The affidavit is being made to justify issuing replacement cards.

Uploaded by

Alexandra Castañeda
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

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF TARLAC )S.S.


CITY OF TARLAC )

AFFIDAVIT OF LOSS

I, RHODA P. GOMEZ, of legal age, Filipino citizen, and resident and


with postal address at San Carlos, Tarlac City, hereby depose and say;

1. That I am a holder of a Philhealth Identification Card issued by


Philhealth and Unified Multi-Purpose ID (UMID) ;

2. That I kept the above-said Identification Cards in my wallet;

3. That sometime on March 2019 I didn’t noticed that my wallet


slipped off from my pocket while I was travelling from work
going to our house at San Carlos, Tarlac City;

4. That despite diligent efforts to look for and locate the same
proved futile; hence, it is presumed as lost and deemed beyond
recovery;

5. That I am executing this affidavit in order to attest to the truth


of the above and to justify the issuance in my favor of a new
Identification Cards of the lost one and for all legal intents and
purposes.

IN WITNESS WHEREOF, I have hereunto set my hands this


__________ at Tarlac City, Philippines.

RHODA P. GOMEZ
Affiant

SUBSCRIBED AND SWORN to before me this ___________at Tarlac


City, Philippines.

Doc. No. _____;


Page No._____;
Book No._____;
Series of 2021.

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