REPUBLIC OF THE PHILIPPINES
CITY/MUNICIPALITY OF ____________
AFFIDAVIT OF LOSS
I, [Your Full Name], of legal age, single/married, Filipino, and a resident of [Your Address], after having been duly sworn in accordance with law, hereby depose and state:
That I am the registered owner of the business known as [Business Name], which is duly registered with the Bureau of Internal Revenue (BIR) under Tax Identification Number (TIN) [Your TIN].
That as part of my business operations and compliance with tax regulations, I have been issued various BIR forms for reporting and remitting taxes.
That on or about [Date of Loss], I discovered that the aforementioned BIR forms (specify forms, e.g., BIR Form 2307, BIR Form 2551M) were missing and despite diligent efforts to locate the same, I have been unable to find them and I believe that they are now lost beyond recovery.
That the loss of the BIR forms was not due to any unlawful or criminal act or negligence on my part.
That I am executing this Affidavit to attest to the truth of the foregoing and for the purpose of requesting the Bureau of Internal Revenue (BIR) to allow me to replace the lost BIR forms.
That I undertake to ensure the proper use and safekeeping of the replacement BIR forms issued to me by the BIR and to promptly report any loss or misuse thereof.
That I further undertake to indemnify the BIR for any damages that may arise from the loss and misuse of the said BIR forms.
IN WITNESS WHEREOF, I have hereunto set my hand this [Date] at [City/Municipality], Philippines.
[Your Full Name]
Affiant
SUBSCRIBED AND SWORN to before me this [Date] at [City/Municipality], affiant exhibiting to me his/her competent evidence of identity by way of [Type of ID] issued on [Date of Issue] at [Place of Issue].
Notary Public
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.
Notes:
[Your Full Name]: Insert your complete legal name.
[Your Address]: Insert your current residential address.
[Business Name]: Insert the registered name of your business.
[Your TIN]: Insert your Tax Identification Number.
[Date of Loss]: Specify the date when you discovered the BIR forms were missing.
[Date]: Insert the date when you are signing the affidavit.
[City/Municipality]: Insert the city or municipality where the affidavit is executed.
[Type of ID]: Insert the type of ID you presented to the notary public (e.g., passport, driver’s license).
[Date of Issue]: The date when the presented ID was issued.
[Place of Issue]: The place where the presented ID was issued.
Ensure to have this affidavit notarized by a licensed notary public.
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