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Affidavit of Loss: Affiant

Raisa C. Salalila executed an affidavit of loss stating that (1) she is an employee of Pampanga Medical Specialist Hospital and was issued a company ID, (2) she believes the ID fell out of her pocket while riding a motorcycle and could not be found despite searching, and (3) she is requesting a new company ID be issued by the HR department of the hospital to replace the lost one. The affidavit was sworn before a notary public on January 20, 2022 in Guagua, Pampanga, Philippines.

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Emmyrain Datu Cruz
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53 views1 page

Affidavit of Loss: Affiant

Raisa C. Salalila executed an affidavit of loss stating that (1) she is an employee of Pampanga Medical Specialist Hospital and was issued a company ID, (2) she believes the ID fell out of her pocket while riding a motorcycle and could not be found despite searching, and (3) she is requesting a new company ID be issued by the HR department of the hospital to replace the lost one. The affidavit was sworn before a notary public on January 20, 2022 in Guagua, Pampanga, Philippines.

Uploaded by

Emmyrain Datu Cruz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF PAMPANGA ) S.S.


MUNICIPALITY OF GUAGUA )
x------------------------------------------ x

AFFIDAVIT OF LOSS

I, RAISA C. SALALILA, of legal age, and a resident of San Matias,


Guagua, Pampanga after having been duly sworn in accordance with law, hereby
depose and state:

That I am employee of PAMPANGA MEDICAL SPECIALIST


HOSPITAL and I was issued a COMPANY ID;

That the said COMPANY ID was placed in my pocket, while I was riding
a motorcycle I didn’t notice that it is missing, probably it fell and nowhere to be
found;

I tried to recover it but I was not able to do so. I further exerted diligent
efforts to locate it but all proved an exercise of futility, hence, my COMPANY
ID is now considered lost;

I am executing this Affidavit to attest to the truth and veracity of all the
foregoing with the intent of requesting the HR DEPARTMENT of the
PAMPANGA MEDICAL SPECIALIST HOSPITAL at Guagua, Pampanga,
to issue me another COMPANY ID in lieu of the lost one.

IN WITNESS WHEREOF, I have hereunto set my hand this 20th of


January, 2022 at Guagua, Pampanga.

RAISA C. SALALILA
Affiant

SUBSCRIBED AND SWORN to before me this 20th of January, 2022 at


Guagua, Pampanga, Philippines.

Doc. No.
Page No. Notary Public
Book No.
Series of.

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