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 I was issued a Certificate of Registration (COR) by the BIR with the following details:
Business Name: [Business Name]
TIN: [Your TIN]
Address: [Business Address]
That on or about [Date of Loss], I discovered that the COR was missing and despite diligent efforts to locate the same, I have been unable to find it and I believe that it is now lost beyond recovery.
That the loss of the COR 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 issue me a replacement Certificate of Registration (COR).
That I undertake to surrender the lost COR to the BIR if found or recovered, and to indemnify the BIR for any damages that may arise from the misuse of the said COR.
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.
[Business Address]: Insert the address of your business.
[Date of Loss]: Specify the date when you discovered your COR was 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.
Make sure to have this affidavit notarized by a licensed notary public.
إرسال تعليق