Transcription of AFFIDAVIT OF LOSS OF PASSPORT
1 AFFIDAVIT OF loss OF PASSPORT The undersigned, Filipino citizen, single/married, presently residing at _____ after having duly sworn to in accordance with law, hereby deposes and says: That the undersigned was issued Philippine PASSPORT No. _____ by the Department of Foreign Affairs in Manila/Consular Extension Office/Philippine Embassy/Consulate in _____ on _____; That said PASSPORT was lost on _____ under the following circumstances: That the undersigned exerted all efforts possible to locate said PASSPORT to no avail; That the undersigned fully understands that the said PASSPORT is automatically deemed cancelled upon declaration of loss , and that if found, it can no longer be used; That undersigned is executing this AFFIDAVIT of loss in connection with his/her present application for a new PASSPORT ; That further Affiant/s sayeth none.
2 IN WITNESS WHEREOF, undersigned hereby affixes his/her signature this _____ day of _____ in _____, USA. _____ Affiant SUBSCRIBED AND SWORN to before me this _____ day of _____ in _____, USA. The Affiant having exhibited to me his/her Identification card No. _____ issued on _____ at _____. _____ Administering Officer/Notary Public
