Republic of the Philippines )

City of General Santos )S.S.

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

AFFIDAVIT OF LOSS
I, JUMAR ALEGADO MENDIG of legal age, Filipino, single and a resident at
Barangay Calumpang, Purok Quilantang, General Santos City Philippines, after
having been duly sworn to in accordance with law, hereby depose and say that:

1. I am a holder of PROFESSIONAL DRIVER’S LICENSE, with No.

___________, duly issued by Land Transportation Office (LTO),
General Santos City

2. Unfortunately, sometime in the year 2014, the abovementioned item

was inadvertently lost and the same must have been misplaced.

3. I have exerted efforts to retrieve the said item but all my efforts were in
vain.

4. The said PROFESSIONAL DRIVER’S LICENSE, was not revoked,

confiscated, or being withheld by lawful authorities for violation of any
law, laws or regulations, or delivered to any person or entity in
connection with any transaction or to secure the payment or
performance of an obligation.

5. I am executing this affidavit to attest under oath to the veracity of the

foregoing and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day

of _____________________ at General Santos City, Philippines.

JUMAR ALEGADO MENDIG

Affiant
ID No.

SUBSCRIBED AND SWORN TO before me this __ day of

________________________________ at General Santos City, Philippines.

Doc. No. ____;

Page No.____;
Book No.____;
Series of 2019.
Republic of the Philippines )
City of General Santos )S.S.
x-----------------------------------------x

AFFIDAVIT OF LOSS
I, LEE JUARES BACOMO, of legal age, Filipino, single and a resident at
opas St., Cor Jade Gem Vill Ma-a, Davao City Davao Del Sur, Philippines, after
having been duly sworn to in accordance with law, hereby depose and say that:

1. I am a holder of OFFICIAL RECEIPT (OR) of my TEMPORARY NON-

PROFESSIONAL DRIVER’S LICENSE, with No.L02-15-006383, duly
issued by Land Transportation Office (LTO), Davao City.

2. Unfortunately, sometime in the year of 2016, the abovementioned item

was inadvertently lost and the same must have been misplaced.

3. I have exerted efforts to retrieve the said item but all my efforts were in
vain.

4. The said OFFICIAL RECEIPT, was not revoked, confiscated, or being

withheld by lawful authorities for violation of any law, laws or
regulations, or delivered to any person or entity in connection with any
transaction or to secure the payment or performance of an obligation.

5. I am executing this affidavit to attest under oath to the veracity of the

foregoing and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day

of _____________________ at General Santos City, Philippines.

LEE JUARES BACOMO

Affiant
ID No.CRN-0111-1595987-0
Issued by UMID, GSC

SUBSCRIBED AND SWORN TO before me this __ day of

________________________________ at General Santos City, Philippines.

Doc. No. ____;

Page No.____;
Book No.____;
Series of 2019.