Republic of the Philippines)

In the City of Davao

)s.s.

AFFIDAVIT OF LOSS
I, JONALD B. ENCABO, of legal age, Filipino and a resident of Davao City,
Philippines after having been sworn to in accordance with law, hereby depose and state
that:
1.

I was issued a drivers license with license no. L0201153079, however the said license
was confiscated when I was apprehended by an LTO enforcer for not wearing my
seatbelt;

2.

After my license was confiscated by the LTO enforcer, he then issued me a Temporary
Operator Permit (TOP);

3.

That on 10 September 2015 when I was arranging my personal documents I noticed that
I am unable to find my Temporary Operator Permit;

4.

I exerted earnest efforts to locate the said TOP but the same could no longer be found
and should now be considered lost and beyond recovery for all intents and purposes;

5.

I am executing this affidavit to attest to the veracity of my statements and to support the
same in completing my requirements for reacquiring my Drivers License form the Land
Transportation Office.
IN WITNESS WHEREOF,
_______________, in Davao City.

hereunto

affix

my

signature

this

JONALD B. ENCABO
Affiant
Competent proof of identity: ______________________
SUBSCRIBED AND SWORN to before me this ________________ by the
affiant who is personally known to me.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2015.