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Affidavit of Loss
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Free Legal Contract Note: It is however wise to consult a lawyer and have a customized document drawn to suit your requirements. Seek legal advice before entering into any agreement or executing any legal document.






WE, (Insert Name of Principal) single/married (insert name of spouse if married), of legal age, with residence and postal address at (Address) do hereby APPOINT (Insert name of Agent /Attorney-In-Fact)) single/married (insert name of spouse if married), likewise of legal age, with postal address at (Address) as our true and legal representative to act for and in our name and stead and to perform the following acts:

To sell, offer for sale, and come to an agreement as to the purchase price and thereafter to sign for us and in our name and receive payment from the sale of our property more particularly described as follows: (Insert Description of Property)

HEREBY GRANTING unto our representative full power and authority to execute and perform every act necessary to render effective the power to sell the foregoing properties, as though we ourselves, have so performed it, and HEREBY APPROVING ALL that he may do by virtue hereof with full right of substitution of his person and revocation of this instrument.


IN WITNESS WHEREOF , WE HAVE HEREUNTO SET OUR HANDS THIS ____ DAY OF _______________ 20__, AT (Insert Place of execution of this Instrument).



_______________________________       __________________________________    

      (Name of Principal)                    (Name of Agent /Attorney-In-Fact)

Signed in the presence of:

  _____________________________        ___________________________________


Republic of the Philippines )
 _________________________) S.S

BEFORE ME, personally appeared:

      Name                                    CTC Number                          Date/Place Issued

    (Name of Principal)                           10000000                     Jan 09, 20__ / Angeles City
         (Name of Agent)                              10000000                     Jan 16, 20__ / City of Manila

Known to me and to me known to be the same persons who executed the foregoing instrument and acknowledged to me that the same is their free and voluntary act and deed.

WITNESS MY HAND AND SEAL, on the date and place first above written.


Notary Public                     

Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.




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