An Affidavit of Loss is a crucial legal instrument in Indonesian jurisdiction, utilized when individuals or organizations need to formally declare the loss of important items, documents, or instruments. This document becomes necessary when seeking replacements for lost items, protecting oneself from potential misuse of lost documents, or fulfilling regulatory requirements. The affidavit must be executed before a Notary Public and requires detailed information about the lost item, circumstances of loss, and steps taken to locate it. It serves multiple purposes including supporting insurance claims, requesting duplicate documents, or protecting the declarant from potential liability. Under Indonesian law, the Affidavit of Loss must comply with specific legal requirements including proper notarization and may need to be accompanied by a police report in certain cases. This document is particularly important in business and personal contexts where proof of loss is required for official procedures.
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1. Title and Declaration: Formal title 'AFFIDAVIT OF LOSS' and opening declaration statement identifying the deponent and their capacity to make the statement
2. Personal Details: Complete identification of the deponent including full name, ID number (KTP), address, occupation, and contact information
3. Item Description: Detailed description of the lost item(s) including all relevant identifying information (serial numbers, registration numbers, dates of issuance, etc.)
4. Circumstances of Loss: Detailed account of when, where, and how the item was lost or discovered to be missing
5. Actions Taken: Description of steps taken to locate the item and report the loss (e.g., police reports, announcements)
6. Purpose Statement: Statement of the purpose for which the affidavit is being made
7. Verification Statement: Declaration that all statements made are true and correct to the best of the deponent's knowledge
8. Execution Block: Space for signature, date, and notary attestation
1. Witness Statement: Additional verification by witness(es) who can attest to the circumstances of loss - used when witnesses were present
2. Police Report Reference: Details of police report if one was filed - included when there's a possibility of theft or when required by authorities
3. Indemnification Statement: Statement protecting third parties from liability - used when the lost item could potentially be misused
4. Previous Document Details: Information about any previous similar affidavits or relevant documents - included when this is not the first affidavit about the loss
5. Language Declaration: Statement that the contents have been explained in the deponent's preferred language - used when the deponent is not fluent in the document's language
1. Copy of Identity Document: Certified copy of deponent's KTP or other valid identification
2. Police Report: Copy of police report if one was filed regarding the loss
3. Supporting Documents: Copies of any documents that help establish ownership or existence of the lost item
4. Public Announcement: Copy of any public announcements made regarding the loss (if applicable)
5. Original Documentation: Copies of any documentation of the original item (photos, registration papers, etc.)
Relevant legal definitions
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Government and Public Sector
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Education
Transportation
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Retail
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Relevant Teams
Legal
Compliance
Administrative Services
Human Resources
Risk Management
Corporate Secretariat
Operations
Facilities Management
Security
Document Control
Relevant Roles
Legal Counsel
Compliance Officer
Risk Manager
Administrative Officer
Human Resources Manager
Corporate Secretary
Document Controller
Security Officer
Facilities Manager
Operations Manager
Office Manager
Property Manager
Records Manager
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Company Director
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