Affidavit of Loss - ATM
Affidavit of Loss - ATM
Affidavit of Loss - ATM
Quezon City ) SS
AFFIDAVIT OF LOSS
I, ________, of legal age and with current residential address at __________, under
oath, state:
3. That sometime in September 2022, I discovered that said ATM card was no longer
in my wallet;
5. That in view thereof, I now desire and hereby request Robinson’s Bank to issue
another ATM card in lieu of the lost one;
6. That I bind myself to save Robinson’s Bank harmless from any loss or damage that
it may incur in connection with the re-issuance of a new ATM card in lieu of the lost
one;
7. That I am executing this affidavit to attest to the foregoing facts and for any legal
purpose it may serve.
Affiant
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