SSS Affidavit of Loss Template

If it so happen that you lost your SSS UMID Card, one of the requirements that you need to prepare to file for an UMID Replacement is an Affidavit of Loss. Some Notary places will prepare this Affidavit of Loss for an additional charge. You can save money if you will prepare and print your own affidavit of loss and just bring it to the notary place for their seal.

Here is an Affidavit of Loss Template, just put your details on the details, double check and print.

REPUBLIC OF THE PHILIPPINES)
_______) S.S.

AFFIDAVIT OF LOSS

That I, __________________________ of legal age, Filipino citizen,
single with residence and postal address at _______________________________
__________________________________________________, after having duly
sworn to in accordance with the law do hereby depose and say:

That I am the owner and in possession of SSS I.D. with number _____
issued by Social Security System (SSS);

That the aforesaid SSS I.D. was lost due to unavoidable circumstances when it was unfortunately misplaced;

That despite of diligent effort has been made to look for the said item mentioned above but proved futile and must therefore considered it lost for all intents and purposes.

That I am executing this affidavit to attest to the truth of foregoing facts and to inform the proper authorities concern and for whatever legal purpose this affidavit may serve.

IN WITNESS WHEREOF, I hereunto set my hand on this _ day of , 20__, in
the City of _.

---

(PRINTED NAME AND SIGNATURE)
Affiant

SUBSCRIBED AND SWORN to before me on this this _ day of 20__, in the City
of __.
Doc. No.
Page No. Notary Public
Book No.
Series of Year

You can have a downloadable Affidavit of Loss template also here