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Affidavit of Loss (ATM)

Sheilla Pecore Jungco filed an affidavit of loss stating that (1) she is the holder of an ATM card issued by Land Bank in 2015, (2) she discovered the ATM card was missing from her wallet in January 2017 after diligently searching for it, and (3) she executed the affidavit to request that Land Bank issue a replacement ATM card since her original card is lost.

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335 views1 page

Affidavit of Loss (ATM)

Sheilla Pecore Jungco filed an affidavit of loss stating that (1) she is the holder of an ATM card issued by Land Bank in 2015, (2) she discovered the ATM card was missing from her wallet in January 2017 after diligently searching for it, and (3) she executed the affidavit to request that Land Bank issue a replacement ATM card since her original card is lost.

Uploaded by

aldin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines )

Puerto Princesa City ) S.S

AFFIDAVIT OF LOSS

I, SHEILLA PECORE JUNGCO, of legal age, Filipino, single and a resident of Acacia Road,
Barangay Tiniguiban, Puerto Princesa City, after having been duly sworn to in accordance
with law, depose and state THAT:

1. I am a holder of Automated Teller Machine (ATM) duly issued in my favor by Land


Bank, in 2015, Puerto Princesa City Branch;

2. I used to put said ATM card in my wallet, but sometime in January 2017, I discovered
that my ATM was no longer in my wallet;

3. I tried to look the said ATM card, despite diligent efforts exerted, I could no longer
locate, find or recover the said ATM card, and to the best of my knowledge, the same
is truly lost;

4. In view thereof, I now desire and hereby request Land Bank to issue another ATM
card in lieu of the lost one;

5. I am executing this affidavit to attest to the foregoing facts and for any legal purpose
it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this June 15, 2017 in Puerto
Princesa City.

SHEILLA PECORE JUNGCO/Affiant


PhilHealth No. 09-025470400-7

SUBCRIBED AND SWORN TO before me June 15, 2017 in Puerto Princesa City,
affiant exhibiting to me his valid proof of identification.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2017.

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