Affidavit of Loss Passport

Lost your passport you will need to present to the Philippines Embassy / Consulate or the DFA these documents:

• Written police report attesting the loss of the passport
• Photocopy of lost passport
• Original and photocopy of PSA issued birth certificate
• Other official identification documents (driver’s license, voter’s ID, seaman’s book, etc.) that prove the applicants identity.

AFFIDAVIT OF LOSS

I, _____________,of legal age, Filipino, (single / married / widow), and a resident of _____________, Philippines, after having been duly sworn in accordance with law, hereby depose and state:

That the undersigned was issued a Philippine Passport by the Department of Foreign Affairs (DFA) in Manila/Consular Office/ Philippine Embassy/Consulate with the following details: Philippine Passport No: _________, Date of Issue: _______, and Issuing Authority: __________.

That the said passport was lost on __________ (Date) under the following circumstances: __________________________________________________________________________________________.

That the undersigned exerted all efforts possible to locate the said passport but to no
avail;

That the undersigned fully understands that the said passport is automatically deemed
cancelled upon declaration of loss and that if found, it can no longer be used;

That the undersigned is executing this Affidavit of Loss in connection with his/her
present application for a new Philippine passport; and

That further Affiant/s sayeth none.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at _____________, Philippines.

AFFIANT

(JURAT)