Scribd Logo
Upload

Welcome to Scribd!

  • 121 views

    SUBSCRIBED AND SWORN To Before Me A Notary Public For and in La Trinidad

    Uploaded by

    black stalker
    Guillermo Challoy Agyapas purchased a flat screen TV from Tiongsan Supermart in September 2017 and was issued an official receipt, which he later destroyed by accidently washing it. He is now requesting a new official receipt be issued by the Land Transportation Office as the original was lost. He affirms the facts in this affidavit are true and accepts any liability from the reissuing of the receipt. The affidavit was sworn to on July 13, 2017 in La Trinidad, Benguet, Philippines.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    SUBSCRIBED AND SWORN To Before Me A Notary Public For and in La Trinidad

    Uploaded by

    black stalker
    121 views2 pages
    Guillermo Challoy Agyapas purchased a flat screen TV from Tiongsan Supermart in September 2017 and was issued an official receipt, which he later destroyed by accidently washing it. He is now requesting a new official receipt be issued by the Land Transportation Office as the original was lost. He affirms the facts in this affidavit are true and accepts any liability from the reissuing of the receipt. The affidavit was sworn to on July 13, 2017 in La Trinidad, Benguet, Philippines.

    Original Description:

    legal

    Original Title

    Affidavit of Loss.agyapas.10.2017.2017

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Guillermo Challoy Agyapas purchased a flat screen TV from Tiongsan Supermart in September 2017 and was issued an official receipt, which he later destroyed by accidently washing it. He is now requesting a new official receipt be issued by the Land Transportation Office as the original was lost. He affirms the facts in this affidavit are true and accepts any liability from the reissuing of the receipt. The affidavit was sworn to on July 13, 2017 in La Trinidad, Benguet, Philippines.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    121 views2 pages

    SUBSCRIBED AND SWORN To Before Me A Notary Public For and in La Trinidad

    Uploaded by

    black stalker
    Guillermo Challoy Agyapas purchased a flat screen TV from Tiongsan Supermart in September 2017 and was issued an official receipt, which he later destroyed by accidently washing it. He is now requesting a new official receipt be issued by the Land Transportation Office as the original was lost. He affirms the facts in this affidavit are true and accepts any liability from the reissuing of the receipt. The affidavit was sworn to on July 13, 2017 in La Trinidad, Benguet, Philippines.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Republic of the Philippines)

    La Trinidad, Benguet) s.s


    x- - - - - - - - - - - - - - - - -x
    AFFIDAVIT OF LOSS

    I, Guillermo Challoy Agyapas, of legal age, married, Filipino, and resident of


    Bayabas, Pico, La Trinidad, Benguet, Philippines, after having been duly sworn to in
    accordance with law, do hereby depose and state THAT:

    1. I purchased from Tiongsan Supermart Incorporated (Tiongsan) located at Km.


    4, Pico, La Trinidad, Benguet a flat screen television (TV) described as
    Pensonic LED -1859 sometime on September 18, 2017. Accordingly, I was
    issued an Official Receipt (OR) for the said purchase by Tiongsan. What I
    recall is that I kept the said OR inside my sling bag at that time.

    2. Thereafter, I brought home the said television. After few weeks of using the
    same, I observed that the said TV experienced malfunction or unsatisfactory
    performance. Therefore, I decided to refer the matter to Tiongsan, the
    dealer/distributor. I was then required to present the Official Receipt thereof.

    3. However, said Official Receipt had been dilapidated and destroyed when I
    erroneously placed my pant containing the Official Receipt into the laundry
    machine. Hence, said document is already rendered totally lost as it is already
    beyond repair and recovery;

    4. The said Official Receipt has not been confiscated by Government authorities
    for violations of law nor surrendered to any private person or entity for the
    enforcement of a civil obligations, but due solely to the foregoing reason;

    5. I am executing this Affidavit to plead and request the office of the Land
    Transportation Office (LTO) to issue me a new Driver’s License Official
    Receipt in lieu of the one which was destroyed and lost. That, I hereby bind
    myself to fully excuse the LTO for any liabilities either civil or criminal that it
    may incur for the issuance of the requested Official Receipt;

    6. Finally, I am executing this affidavit to attest to the truthfulness of the


    foregoing facts and for all legal intents and purposes it may serve well.

    IN WITNESS WHEREOF, I have hereunto set my hand this 13 th day of July


    2017, at La Trinidad, Benguet, Philippines.

    CRISANTO C. CAYABAS
    Affiant
    Senior Citizen’s ID No.: 2010-2632
    Issued at: Itogon, Benguet
    Issued on: April 1, 2013

    SUBSCRIBED AND SWORN to before me a Notary Public for and in La Trinidad,


    Benguet, Philippines this 13th day of July, 2017, by the above Affiant, who exhibited to me his
    ID as competent evidence of identity with picture above his name and identified by me to be the
    same person who personally signed before me the foregoing Affidavit.

    ATTY. JOECLE R. DONGLA


    Doc. No. 443 Notary Public,
    Page No. 89 My commission expires on January 5, 2019
    Book No. IV TIN No.431-403-131; Roll No. 60543, 3-23-2012
    Series of 2017 PTR No. 5012179, January 5, 2017, Benguet;
    IBP No. 1039762; December 13, 2016; Baguio-Benguet
    S&B Bldg. FA 224, Km. 4, La Trinidad, Benguet

    You might also like