Pasig City
) S.S.
x----------------------------x
AFFIDAVIT OF LOSS
I, NELY A. SALVADOR, of legal age, Filipino, married and a resident of No. 30A J. Ramos St., Ibayo-Tipas, taguig City, after having been duly sworn to in
accordance with law, depose and state THAT:
1. I pawned a necklace, wedding ring and a ladys ring at Cebuana Lhullier
Pasig last June 20, 2016 evidenced by pawn receipt number
10921SG032644, 10921SG032645 and 10921SG032646 respectively;
2. Sometime on September 30, 2016, said pawn receipts was misplaced and
got lost;
3. Efforts were exerted to locate said pawn receipts, but in spite of diligent
search, it could not be found and the same is now beyond recovery;
4. Said pawn receipts has not been sold or transferred to another person;
NELY A. SALVADOR
Affiant
SSS ID No. _____________
AFFIDAVIT OF LOSS
I, NELY A. SALVADOR, of legal age, Filipino, married and a resident of No. 30A J. Ramos St., Ibayo-Tipas, taguig City, after having been duly sworn to in
accordance with law, depose and state THAT:
1. I pawned a ladys ring, earring pair and a pendant at Cebuana Lhullier
Pasig last June 21, 2016 evidenced by pawn receipt number
10921SG032665, 10921SG032666 and 10921SG032667 respectively;
2. Sometime on September 30, 2016, said pawn receipts was misplaced and
got lost;
3. Efforts were exerted to locate said pawn receipts, but in spite of diligent
search, it could not be found and the same is now beyond recovery;
4. Said pawn receipts has not been sold or transferred to another person;
NELY A. SALVADOR
Affiant
SSS ID No. _____________