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Affidavit

1. Yuuko Shane M. Mogami and Reginabelle M. Mogami owned Japanese and dual passports respectively that they last used in 2006 during travel to Japan. They stored the passports with their cousin for safekeeping. 2. In January 2013, a fire destroyed their cousin's entire house and the passports along with other belongings. 3. Despite efforts, Yuuko and Reginabelle were unable to locate their passports as they were destroyed beyond recovery in the fire. They attest that the passports were not confiscated but destroyed by the fire.

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Gerra Padillo-Palsario
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23 views3 pages

Affidavit

1. Yuuko Shane M. Mogami and Reginabelle M. Mogami owned Japanese and dual passports respectively that they last used in 2006 during travel to Japan. They stored the passports with their cousin for safekeeping. 2. In January 2013, a fire destroyed their cousin's entire house and the passports along with other belongings. 3. Despite efforts, Yuuko and Reginabelle were unable to locate their passports as they were destroyed beyond recovery in the fire. They attest that the passports were not confiscated but destroyed by the fire.

Uploaded by

Gerra Padillo-Palsario
Copyright
© © All Rights Reserved
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Download as doc, pdf, or txt
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REPUBLIC OF THE PHILIPPINES)

CITY OF TALISAY )
PROVINCE OF CEBU )S.S

AFFIDAVIT OF LOSS
I, YUUKO SHANE M. MOGAMI, minor, Filipino, single, and a resident of
Quiot, Pardo, Cebu City, after being duly sworn in accordance with law, hereby
depose and say, that:

1. I am an owner of a Japanese Passport which I last used on the year 2006


for our 2 month travel in Nagoya, Japan. I gave it to my cousin for
safekeeping. She put it in a drawer in their house;

2. On January 2013, a fire occurred at 2 in the afternoon. It destroyed the


entire house along with their belongings, and my Japanese Passport.

3. Immediately thereafter, I exerted all my efforts to locate the said


Passport, to see it did was not completely destroyed.However, my efforts
proved futile since the same was already ruined beyond recovery;

4. I hereby attest that the said Japanese Passport was destroyed by cause
of fire. It was not confiscated for any violation of rules and regulations;

5. This affidavit is executed by me for whatever legal purpose this may


serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4 th day of


June, 2013 at the City of Talisay, Cebu.

Assisted by:

YUUKO SHANE M. MOGAMI EDNA M. MOGAMI


Affiant Parent
Student ID No. 12-1248-551 ________________________
CIT University ________________________

SUBSCRIBED AND SWORN TO, before me on the date and at the place
above written. I further certify that I have examined the affiant and that she
attests that she understood the foregoing sworn statement.

Doc. No.
Page No.
Book No.
Series of 2013.
REPUBLIC OF THE PHILIPPINES)
CITY OF TALISAY )
PROVINCE OF CEBU )S.S

AFFIDAVIT OF LOSS
I, REGINABELLE M. MOGAMI, of legal age, Filipino, single, and a
resident of Quiot, Pardo, Cebu City, after being duly sworn in accordance with
law, hereby depose and say, that:

1. I am an owner of a Dual Passport which I last used on the year 2006 for
our 2 month travel in Nagoya, Japan. I gave it to my cousin for
safekeeping. She put it in a drawer in their house;

2. On January 2013, a fire occurred at 2 in the afternoon. It destroyed the


entire house along with their belongings, and my Dual Passport.

3. Immediately thereafter, I exerted all my efforts to locate the said


Passport, to see it did was not completely destroyed. However, my efforts
proved futile since the same was already ruined beyond recovery;

4. I hereby attest that the said Dual Passport was destroyed by cause of
fire. It was not confiscated for any violation of rules and regulations;

5. This affidavit is executed by me for whatever legal purpose this may


serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4 th day of


June, 2013 at the City of Talisay, Cebu.

REGINABELLE M. MOGAMI
Affiant
Student ID No. 2010-03065
CIT University

SUBSCRIBED AND SWORN TO, before me on the date and at the place
above written. I further certify that I have examined the affiant and that she
attests that she understood the foregoing sworn statement.

Doc. No.
Page No.
Book No.
Series of 2013.

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