Affidavit of Lost Passport

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AFFIDAVIT OF LOSS

I, ___________________, of legal age, Filipino, single and a resident of


_______________________________, after having been duly sworn to in accordance with law,
depose and state THAT:

1. On January 12, 2010, I was issued a Philippine Passport by the Department of Affairs in
Manila;

2. Recently, I had tried to look for the said passport but the same could not be found;

3. Despite diligent search and efforts to locate the said passport, I could not find the same such
that I believe that it is now lost beyond recovery;

4. As such, I am executing this affidavit to attest to the foregoing facts and to support the
application for the issuance of a new one in lieu of the one which was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ in Makati


City, Metro Manila, Philippines.

____________________
Affiant

SUBCRIBED AND SWORN TO before me this ___________________ in


_________________, Philippines, affiant exhibiting to me his valid proof of identification
______________

NOTARY PUBLIC

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2015.

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