Affidavit of Loss - ORCR

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Republic of the Philippines

) S.S.

AFFIDAVIT OF LOSS

I, ______________________, Filipino, of legal age, and with residence and postal


address at ___________________________________________________________,
after having been duly sworn on oath in accordance with law, hereby depose and state:

1. That I am the duly registered and lawful owner of a certain ________________


with Plate No. ________________ (hereinafter referred to as the VEHICLE);

2. That the abovementioned VEHICLE is registered with the Land Transportation


Office (LTO) under Official Receipt (OR) no. ________________ and Certificate
of Registration (CR) no. ________________ (hereinafter referred to as OR/CR);

3. That I usually place the abovementioned OR/CR at ________________;

4. That sometime on ______________, I searched for the abovementioned OR/CR


and discovered that they are already missing;

5. That despite diligent efforts the same cannot be located or recovered;

6. That for all intents and purposes, the abovementioned OR/CR are considered
LOST;

7. That I am executing this affidavit to attest to the truth and veracity of the
foregoing statements and for the purpose of requesting a copy of the
abovementioned OR/CR from LTO;

Further, affiant sayeth naught.

IN TRUTH WHEREOF, I have hereunto signed my name below, this _______________


at _______________.

__________________________
Affiant

SUBSCRIBED AND SWORN TO before me this _____________ at _______________,


Affiant exhibited his/her ________________ as valid and competent evidence of
identity.

Doc. No.
Page No.
Book No.
Series of 2022

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