��������Ƶ

An Affidavit of Loss Passport is a crucial document required under Indonesian law when an individual needs to report and officially declare a lost or stolen passport. This sworn statement, governed by Indonesian immigration regulations and administrative law, serves as a formal declaration of the loss and is a prerequisite for obtaining a replacement passport. The affidavit must contain specific details about the lost passport, including its number, issuance details, and the circumstances of its loss. It is typically required to be notarized and accompanied by a police report. This document is particularly important as it helps prevent misuse of lost passports and forms part of the official record for both Indonesian nationals and foreign residents dealing with passport-related issues in Indonesia.

1. Title and Declaration: Formal title 'AFFIDAVIT OF LOSS' and opening declaration stating this is a sworn statement

2. Deponent Information: Full identification details of the person making the affidavit including full name, date of birth, nationality, occupation, and current address

3. Lost Passport Details: Complete details of the lost passport including passport number, date and place of issuance, expiry date, and issuing authority

4. Circumstances of Loss: Detailed account of when, where, and how the passport was lost or stolen, including the last time it was seen and any relevant circumstances

5. Police Report Reference: Details of the police report filed regarding the loss, including report number and date

6. Prior Search Declaration: Statement describing efforts made to locate the lost passport

7. Non-Recovery Statement: Declaration that the passport has not been found or recovered

8. Truthfulness Declaration: Formal statement affirming that all information provided is true and correct

9. Legal Implications Understanding: Statement acknowledging understanding of legal implications of making a false declaration

10. Signature Block: Space for deponent's signature, date, and place of signing