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Free · Philippine format · ready to print

Affidavit of loss for an ATM card

An affidavit of loss for a lost ATM or debit card, naming the bank, branch and the last digits of the card — the format banks ask for. Type on the page, free PDF.

How to fill in this affidavit of loss

  1. 1City or municipality
    e.g. CITY OF QUEZON
  2. 2Your full name
    e.g. Juan Carlo M. Reyes
  3. 3Civil status
    e.g. single
  4. 4Your address
    e.g. No. 27 Sampaguita St., Brgy. Teachers Village East, Quezon City
  5. 5Bank
    e.g. Banco de Oro (BDO)
  6. 6Branch
    e.g. SM City Fairview

Call the bank first

Before anything else, call your bank's hotline or use its app to block the card — an affidavit does not stop anyone from using it. Then bring this affidavit, notarized, with a valid ID to your branch to ask for a replacement.

How to get it notarized

Fill the paper here, download the PDF and print it — but do not sign it yet. The notary must watch you sign.

  • Bring the printed affidavit, unsigned, in two or three copies.
  • Bring one valid government ID; its details go into the jurat.
  • Sign in front of the notary, who signs, seals and numbers it.
  • Keep one copy; give the original to the office that asked for it.

Write the facts, not a story

A short, specific affidavit is accepted faster than a long one. Say what was lost, when and roughly where, and that you searched for it. Do not guess — if you are not sure of the exact date, write "on or about" the date, as this paper does.

Never write the full card number or PIN

Write only the last four digits of the card. The bank finds the card from your name and account; the full number and the PIN never belong on paper.

Questions people ask

Does every bank ask for an affidavit?

Not always. Many banks replace a card with just a request form and an ID, and charge a replacement fee. Ask your branch; if they want an affidavit, this is the format.

Does an affidavit of loss need to be notarized?

Yes. An affidavit is a SWORN statement: print it unsigned, bring it and a valid ID to a notary public, and sign it in front of them. The notary fills in the jurat (the "Subscribed and sworn" part) and the Doc, Page, Book and Series numbers. Notarial fees are usually a few hundred pesos.

Do I need a police report too?

Some offices ask for one, especially for a stolen ID, a stolen vehicle document or a lost passport. A police blotter is free at the station where it happened. Ask the office that will replace the item before you go.

Is this legal advice?

No. DocsOfUs gives you the common Philippine format so you can prepare the paper quickly. The office that will receive it, and the notary, decide what they accept. If the loss involves money, a dispute or a crime, talk to a lawyer or the Public Attorney's Office (PAO).

What if I find the item later?

Report it to the office that issued the replacement. A replaced card or document is usually cancelled once the new one is issued, so the found one should no longer be used.

This page explains common practice and is not legal advice. Offices set their own rules — when in doubt, call ahead or ask your notary or lawyer.