Affidavit of Loss Debit Card

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AFFIDAVIT OF LOSS

I, Micaela Angela Padua, of legal age, Filipino, and a resident of 5 Atis Street Doña Josefa Village
Almanza Uno Las Piñas City, after having been duly sword in accordance with law, do hereby
depose and state:
That I am the holder/owner of the item below:

 Unionbank Debit card account number ending in 0576

That the said Unionbank debit card was inadvertently lost and/or misplaced from my
possession.

That despite of diligent search and efforts to locate the said debit card, I could not find
the same such that I now believe that is not now lost beyond recovery.

That I am executing this affidavit of loss to attest to the truth of the foregoing and to
support the application for the issuance of a new one in lieu of the one which was lost
and for whatever legal intent this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this ___ day of ___________ in
Manila Philippines.

Micaela Angela Padua


Affiant

SUBSCRIBED AND SWORN before me this ____ day of ________ in Manila, Philippines.

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