Affidavit of Loss
Republic of the Philippines · Template v0.2.0
REPUBLIC OF THE PHILIPPINES )
MAKATI CITY ) S.S.
SWORN STATEMENT
I, Maria L. Santos, Filipino, of legal age, single, and residing at 100 Ayala Avenue, Makati City 1226, after having been duly sworn in accordance with law, depose and state:
1. I am the registered owner or lawful holder of the item described below.
2. The subject item is Professional Identification Card bearing identifier PIC-1234567, issued by Professional Regulation Commission. The registered owner or holder is Maria L. Santos.
3. The item was lost on August 15, 2026. The place where I last possessed, used, or kept it: inside my wallet while traveling from my office in Makati City to my residence. The first-hand circumstances are: I used the card at my office in the morning, placed it back inside my wallet, and discovered after arriving home that the card was no longer in the wallet.
4. I discovered the loss or destruction on August 15, 2026 in the following manner: I checked my wallet at home that evening and found that the card was missing while the other contents remained.
5. I made a diligent search, including the following reasonable steps: I searched the wallet, bag, office desk, vehicle, and residence and contacted the building reception and transport provider. Despite that search, the item remains missing or has been confirmed destroyed.
6. I did not knowingly sell, assign, pledge, lend, or voluntarily deliver the item to another person. I am not using this affidavit to conceal a transfer, ownership dispute, or unauthorized possession.
7. I am not presently aware of specific facts establishing unauthorized use after the loss. I will report any verified misuse promptly.
8. I notified Professional Regulation Commission: Reported through the PRC help channel on August 16, 2026 under reference PRC-AL-221. I confirmed that a police report is not required for the presently identified submission.
9. I am executing this affidavit for submission to Professional Regulation Commission to request the issuance of a replacement. This affidavit does not itself cancel the item, determine ownership, or compel replacement.
10. I will provide only genuine supporting records and comply with the recipient's current official requirements.
11. This is loss number 1 for this same kind of item based on my records and recollection. If the item is recovered, I will promptly notify Professional Regulation Commission, stop using any canceled or replaced version, and surrender or handle it as lawfully directed.
12. I have read and understood this Affidavit. Its material statements are true and complete based on my personal knowledge and the records expressly identified above. I understand that knowingly making a material false statement under oath for a legal purpose may result in criminal and other liability.