Affidavit of Loss (Philippines) — Free Sample and Generator

REPUBLIC OF THE PHILIPPINES )
CITY OF QUEZON CITY ) S.S.
x----------------------------------------x

AFFIDAVIT OF LOSS

I, [JUAN M. DELA CRUZ], of legal age, single, Filipino, and a resident of [123 Mabini Street, Barangay Santo Niño, Quezon City], after having been duly sworn in accordance with law, hereby depose and state that:

1. I am the registered holder of [Unified Multi-Purpose ID (UMID) No. 0123-4567890-1] issued to me by the Social Security System on [15 March 2021];

2. On or about [12 August 2026], while commuting along [EDSA, Quezon City], I discovered that the said identification card was no longer in my wallet;

3. I immediately retraced my route, inquired at the establishments I had visited that day, and reported the matter to [Barangay Santo Niño / the PNP station of Quezon City], but despite diligent search and effort the said card has not been found and is now considered permanently lost;

4. The said card was not used, and has not been used, as collateral, security, or for any unlawful or fraudulent purpose, and I undertake to surrender it to the issuing office should it be recovered;

5. I am executing this affidavit to attest to the truth of the foregoing facts and for the purpose of securing a replacement of the said identification card from the [Social Security System], and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of __________, 20____, at Quezon City, Philippines.

                                        ______________________________
                                        [JUAN M. DELA CRUZ]
                                        Affiant

SUBSCRIBED AND SWORN to before me this ____ day of __________, 20____, at Quezon City, affiant exhibiting to me [his Philippine Passport No. P1234567A] as competent evidence of identity.

                                        ______________________________
                                        Notary Public

Doc. No. ______;
Page No. ______;
Book No. ______;
Series of 20____.

What an affidavit of loss actually does

An affidavit of loss is a sworn written statement that something of yours — an ID, an ATM card, a SIM, an official receipt, a certificate of registration, a passbook, a land title — is lost, that you searched for it, and that it has not been used for anything unlawful. It does not replace the lost item. What it does is give the office that issued the item a document they can put in their file to justify issuing a replacement, and to shift the responsibility for the loss onto you.

That is why the wording matters more than people expect. Offices are not reading it for style; they are checking three things: that you are the registered holder, that you describe the item precisely enough to identify it in their system, and that you swear it was not used as collateral or for fraud. An affidavit missing the card or document number is routinely bounced back at the counter.

When you need one — and when you do not

What to prepare before you draft it

How to fill it in, clause by clause

1. 1

   The venue line (Republic of the Philippines / City of ___ ) S.S.)

   This is the place where you will sign in front of the notary — not necessarily where you lost the item, and not necessarily where you live. A notary public's commission is limited to a particular city or province, so this line has to match the notary's commission.

2. 2

   The affiant's description

   Full name, of legal age, civil status, citizenship, and residence. Use the name in the issuer's records. If your ID says 'Juan M. Dela Cruz' and you sign 'John Dela Cruz', expect the counter to reject it.

3. 3

   Paragraph 1 — ownership

   State that you are the registered owner or holder, and identify the item with its number and issuing office. This is the paragraph that lets the clerk find you in their system.

4. 4

   Paragraph 2 — the loss

   Give the date and the circumstances as precisely as you honestly can. 'On or about' is acceptable when you are not certain of the exact date. Do not invent detail — this is sworn.

5. 5

   Paragraph 3 — the diligent search

   Say what you actually did to find it. This is the clause most home-made affidavits skip, and it is the one that makes the document credible.

6. 6

   Paragraph 4 — no unlawful use

   State that the item was not used as collateral or security and has not been used for any unlawful purpose, and that you will surrender it if found. Banks and the LTO look specifically for this.

7. 7

   Paragraph 5 — the purpose

   Name the office you are submitting it to and what you want from them. 'For whatever legal purpose this may serve' alone is weaker than naming the issuing office.

8. 8

   The jurat — leave it blank

   The 'SUBSCRIBED AND SWORN' block, the notary's signature, and Doc./Page/Book/Series are filled in by the notary. Never pre-fill or sign them.

Where to submit it, and what else each office wants

Legal basis: 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC), Rule II sec. 6 (jurat) and Rule II sec. 12 (competent evidence of identity); Revised Penal Code art. 183 (perjury); RA 11934 (SIM Registration Act) for SIM replacement; PD 1529 sec. 109 (notice and replacement of a lost owner's duplicate certificate) and sec. 110 with RA 26 (reconstitution of a lost or destroyed original certificate of title on file with the Register of Deeds).

Lost land title: two different proceedings, often confused

People use “reconstitution” loosely for any lost title, and the two situations are governed by different provisions. What was lost decides which one you are in.

Lost ID, SIM card, or receipt — the three special cases

Lost ID

Name the exact ID and its number, the issuing agency, and the date of issue. Each agency has its own replacement form and fee, and most will not accept an affidavit older than about six months. If the ID was taken in a snatching or a break-in, get a police blotter entry as well — the agency will usually ask for it, and a blotter costs nothing.

Lost SIM card

Since the SIM Registration Act (RA 11934), your number is tied to your registered identity, so the telco needs to be satisfied you are the registered subscriber before it re-issues the SIM with the same number. Bring the affidavit, a valid ID matching the registration, and whatever proof of ownership you have — the old packaging, load receipts, or the registration confirmation message. Report the loss immediately so the SIM can be deactivated; a lost, still-active SIM is an account-recovery risk for every service tied to that number.

Lost official receipt or certificate of registration (vehicle)

The LTO will ask for the affidavit of loss plus a PNP-HPG motor vehicle clearance and stencils of the engine and chassis numbers. If you are also selling the vehicle, do the OR/CR replacement first — a buyer cannot transfer registration without them.

What if…

1. 1

   …you find the item after signing

   Stop the replacement request and tell the issuing office. Using a replacement while holding the original is exactly the kind of double use the 'no unlawful purpose' clause is there to prevent.

2. 2

   …the office rejects your affidavit

   The usual reasons are a missing card number, a name that does not match their records, a blank Doc. No. in the jurat, or an affidavit older than their internal cut-off. Ask what specifically is wrong, fix that line, and have it re-notarised.

3. 3

   …you are abroad

   Execute it at the Philippine Embassy or Consulate with jurisdiction over where you live; consular notarisation has the same effect. A local foreign notary is not enough on its own — that document has to be apostillised before it will be accepted in the Philippines.

4. 4

   …you cannot afford a notary

   Ask the Public Attorney's Office, your city or municipal legal office, or the IBP chapter's legal aid desk. Many notarise for indigents free of charge on presentation of a certificate of indigency from your barangay.