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Affidavit of Loss: Kappa Community Ministry, International, Inc. Kidapawan City

1. Cristina Birang Carbonell lost her Certificate of Membership for a Deed of Donation from Kappa Community Ministry, International, Inc. worth 5,000 pesos that was in her possession in Kidapawan City on April 12, 2019. 2. Despite her efforts, she was unable to locate the lost certificate. 3. She executed an affidavit to attest to losing the certificate and to request that Kappa Community Ministry issue a replacement.

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Angelica Branzuela Pagal Aninipot
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128 views

Affidavit of Loss: Kappa Community Ministry, International, Inc. Kidapawan City

1. Cristina Birang Carbonell lost her Certificate of Membership for a Deed of Donation from Kappa Community Ministry, International, Inc. worth 5,000 pesos that was in her possession in Kidapawan City on April 12, 2019. 2. Despite her efforts, she was unable to locate the lost certificate. 3. She executed an affidavit to attest to losing the certificate and to request that Kappa Community Ministry issue a replacement.

Uploaded by

Angelica Branzuela Pagal Aninipot
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines}

Province of Cotabato }s.s


Kidapawan City }
x-------------------------------------x

AFFIDAVIT OF LOSS
I, CRISTINA BIRANG CARBONELL, of legal age, Filipino, married
and a resident of Brgy. Sudapin, Kidapawan City after having been
duly sworn to in accordance with law, do hereby depose and say;

That I am the holder of CERTIFICATE OF MEMBERSHIP issued by


Kappa Community Ministry, International, Inc. Kidapawan City;

That on April 12, 2019, the aforementioned Copy of my


CERTIFICATE OF MEMBERSHIP for DEED OF DONATION with a certain
amount of money worth of FIVE THOUSAND PESOS (P5, 000) was lost
in my possession somewhere in the vicinity of Kidapawan City;

That despite of my earnest efforts to locate the same but proved


futile, hence aforementioned Copy of CERTIFICATE OF MEMBERSHIP
for DEED OF DONATION was now considered lost and beyond
recovery;

That I am executing this statement to attest to the truthfulness


and veracity of the foregoing facts to request the Kappa
Community Ministry to issue another CERTIFICATE OF MEMBERSHIP for
DEED OF DONATION in lieu of the one lost and for whatever legal
intent and purposes which may serve best.

IN WITNESS WHEREOF, I have hereunto set my hand below this


9th day of October 2019 at Kidapawan City, Philippines.

CRISTINA BIRANG CARBONELL


Affiant
OSCA No. 14161

SUBSCRIBED AND SWORN to before me this 9th day of October


2019 at Kidapawan City, Cotabato, Philippines. Affiant exhibited her
Identification Card Number indicated below her name.

Doc. No. 402 ATTY. OSCAR D. BAYOG


Page No. 79 Notary Public
Until December 31, 2020
Book No. 01 Roll No.18081
Series of 2019 IBP Life Time Member
IBP OR No. 1009201/9-4-2015
O.R. No. 1012991/12-15-2015
PTR No. 1946948/01-08-2019
MCLE Compliance No. VI-0013914:Valid until April 14,2022
2/F GSP Building, Quirino Drive, Kidapawan City
Notarial Com. No. 132-2019

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