Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                

Affidavit of Loss.

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Republic of the Philippines)

La Trinidad, Benguet) s.s


x- - - - - - - - - - - - - -x

AFFIDAVIT OF LOSS OF OFFICIAL RECEIPT

I, Felino L. Quia, of legal age, married, Filipino, and resident of Km.3, Naguilian Road,
Irisan, Baguio City, 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 Television (TV) with SERIAL No.
3TE32G21382T0iC6QA11551; Model 32A4GS Hisense and TR No. 1171861,
sometime on March 30, 2022. Accordingly, I was issued an Official Receipt (OR) for
the said purchase by Tiongsan. What I recall is that I got the receipt after I pay the
necessary amount and put the said OR inside the TV box for safekeeping;

2. Thereafter, I brought home the said Television. After few weeks of using it, to our
surprised when we turned on the said Television it has no picture anymore. Therefore,
I decided to refer the matter to Tiongsan, the seller/dealer/distributor. I was then
required to present the Official Receipt (OR) thereof;

3. However, when I tried to locate the said OR inside the TV box, to my dismayed and
aghast the TV box and OR was nowhere to be found. Immediately, I searched the
same within the premises and even asked my family member but still I was unable to
locate it;

4. Despite diligent efforts exerted, I was not able to locate the afore-mentioned OR until
now. Therefore, I considered it lost and beyond recovery. The loss of the same is not
deliberate but purely due to mere inadvertence or excusable neglect;

5. 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 6th day April 2022, at La
Trinidad, Benguet, Philippines.

Felino L. Quia
Affiant
Driv. License No. A04-08-004121

SUBSCRIBED AND SWORN TO before me this 6th day of April 2022, at La Trinidad,
Benguet, Philippines by the affiant who is personally known to me to be the same person who
signed the foregoing Affidavit.

ATTY. CYRUS C. CALAYA


Doc. No. 93; Notary Public until June 30, 20221
Page No. 20; PTR No. BGTCF 7309058; January 18,2022
Book No. V; IBP Lifetime No. 08051, at Pasig City
Series of 2022. Roll No. 52590, May 12, 2006; Manila
Sunburst Bldg., FA 224, Km. 4,
La Trinidad, Benguet

1
As per Bar Matter 3795 dated September 28, 2021.

You might also like