Jira & Confluence 
Bitrix24 Affidavit of Loss · Philippines · Word
Affidavit of Loss sample — what to bring to the notary
Short answer. The filled sample is open below. What to write: your identity, the exact lost item or document, identifying numbers if known, when and where it was lost, the diligent search and the purpose of the affidavit (Facts within the affiant's personal knowledge).
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- Personal appearance before the notarytype the date
Check your own case.
Do not sign ahead of time unless the notary tells you to. A jurat requires personal appearance, identification and signing or swearing before the notary.
Liza, Layers template assistant
Use facts you personally know: the item, the last time you had it, what happened and where you searched.
Call the receiving agency before the notary. Its checklist decides the wording, number of originals and extra IDs you need.
Deadlines
The rules, with the source
| What | Deadline | Source |
|---|---|---|
| What to write | Your identity, the exact lost item or document, identifying numbers if known, when and where it was lost, the diligent search and the purpose of the affidavit | Facts within the affiant's personal knowledge |
| What to bring | The unsigned affidavit, at least one current official ID with photograph and signature, and any copy or record showing the lost item's number | 2004 Rules on Notarial Practice, Rule II |
| At the notary | Appear personally, show the original ID, sign and swear to the affidavit as the notary directs | 2004 Rules on Notarial Practice — jurat |
| Notary fee | There is no single price printed on this template; ask the notary for the fee before the appointment and request a receipt | Fee varies by office and location |
| Where to submit | Take the notarized original to the agency or issuer replacing the item and follow its own checklist | Receiving agency's current requirements |
An Affidavit of Loss records your sworn account; it does not itself replace the lost item. The receiving bank or agency decides whether it needs the original, a copy, its own form or additional identification.
Step by step
What to do, in order
1
Identify the lost item
Write the exact ID, card, certificate, OR/CR or document and its number if you know it.
2
Describe the loss
State the date, place and circumstances truthfully; do not guess details you cannot remember.
3
Record your search
Say where you looked and that the item has not been recovered.
4
Bring it unsigned
Take the draft, original government photo ID and a copy or record of the lost item to the notary.
5
Sign before the notary
Appear personally and follow the notary's jurat procedure. Ask the fee first and keep the receipt.
6
Submit it to the issuer
LTO requires the original affidavit for a duplicate driver's license; banks and other issuers have their own checklists. For a PSA civil-registry copy, first check whether you can simply order another copy and whether an affidavit is required.
Questions
Does an Affidavit of Loss need to be notarized?
For the usual replacement process it is a sworn affidavit with a jurat. You appear personally, show competent evidence of identity and sign or swear as the notary directs.
How much does an Affidavit of Loss cost?
Notary fees vary by office and location. Ask for the price before the appointment and for a receipt; the receiving agency may charge a separate replacement fee.
What do I take to LTO?
LTO's published checklist for a duplicate driver's license includes the accomplished APL form, the original Affidavit of Loss or mutilated license, and an original plus photocopy of a valid photo-and-signature ID. Check the latest LTO checklist before going.
Do I take this to a bank or PSA?
Take it to the bank or issuer only after checking that institution's current replacement checklist. PSA certificates can normally be ordered again; ask PSA or the Local Civil Registry whether your particular correction or replacement process requires an affidavit.
What is an affidavit of undertaking?
It is a different sworn promise to do or avoid something. Use the Affidavit of Loss only to state the facts of the loss and the actions connected with replacement.
Official sources
Other documents
Keep the papers in one place
Letters, receipts and notices in one folder you can share with family or a lawyer. The templates and the editor are free; Layers is free for up to 20 people.
A general sample, not legal advice. The bank, LTO, PSA/LCR or other receiving agency may require its own wording and additional documents.