Republic of the Philippines )

City of Masbate) S.S.

x--------------------------x

AFFIDAVIT OF DESTRUCTION/MUTILATION

I, Jose Edrin S. Narciso, of legal age, married, Filipino , and

presently residing at Brgy. Del Rosario,Uson, Masbate, after having been
duly sworn to in accordance with law, do hereby depose and say:

1. That I am a holder of Philippine Drivers license issued by the

Land Transportation office ( LTO);

2. That the said Drivers license was damaged/mutilated due to

deterioration.

3. That the damage on the said license has rendered it unusable

for purposes of identification and a replacement is the only
remedy;

4. That I attest to the veracity of the foregoing information.

IN WITNESS WHEREOF, I have hereunto set my hand this 10th. day

of October, 2017 at Masbate City, Philippines.

________________
Affiant

SUBSCRIBED AND SWORN to before me this 10th. day of October,

20178 in Masbate City. Philippines.

Doc No. : ___;

Page No.: ___;
Book No.: II
Series of 2017