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AFFIDAVIT OF LOSS
I, JEFFREY MAGNO, Filipino, of legal age, married and a resident of Tarlac City,
after having been duly sworn to in accordance with law do hereby depose and state:
2. That as such I was issued an ATM Card with Savings Account by the Land Bank
of the Philippines, Tarlac branch, the ATM No. of which is I could no longer be
remembered;
3. That sometime on May 20, 2017, after I took my salary said ATM Card was
misplaced by me;
4. That I exerted all necessary efforts to locate it, but the same could no longer be
found;
5. That I am executing this affidavit to inform the Land Bank of the Philippines,
Tarlac branch and or proper authorities about the situations for possible
retrieval/replacement of the same and for whatever legal purpose this affidavit
may duly serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 24 th day of May 2017 at
Tarlac City, Philippines.
JEFFREY MAGNO
Affiant
SUBSCRIBED AND SWORN to before me this 24 th day of May 2017 at Tarlac City,
Philippines by JEFFREY MAGNO.
AFFIDAVIT OF LOSS
2. That as such I was issued an ATM Card with Savings Account by the Land Bank
of the Philippines, Tarlac branch, the ATM No. of which is I could no longer be
remembered;
3. That on January 9, 2018, while I was on a vacation leave, while riding on a public
vehicle the said wallet including the ATM card was lost, now I considered the said
wallet was missing;
4. That I exerted all necessary efforts to locate it, but the same could no longer be
found;
5. That I am executing this affidavit to inform the Land Bank of the Philippines,
Tarlac branch and or proper authorities about the situations for possible
retrieval/replacement of the same and for whatever legal purpose this affidavit
may duly serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 10 th day of January 2018
at Tarlac City, Philippines.
NELSON V. VICTORIA
Affiant
AFFIDAVIT OF LOSS
2. That when I was about to locate said ATM card, I found out it was
missing, and I exerted all necessary efforts to locate it, but the
same could no longer be found;
JUANCHO A. GONZALES
Affiant
AFFIDAVIT OF LOSS
I, MARC IAN O’NEAL D. SAN JUAN, Filipino, of legal age, single and
a resident of #267 Sitio Bungil, Sapang Maragul, Tarlac City, after having
been duly sworn to in accordance with law do hereby depose and state:
1. That I am a holder of ATM Card issued by the Union Bank with the
account number 109650479300, at Tarlac Branch;
3. That when I was about to locate said ATM card, I found out it was
missing, and I exerted all necessary efforts to locate it, but the
same could no longer be found;
AFFIDAVIT OF LOSS
2. That on March 16, 2018, when I was about to withdraw, the said
ATM card, was misplaced, and I exerted all necessary efforts to
locate it, but the same could no longer be found;
EMILY C. BASILIO
Affiant