REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BATANGAS ) S. S.
CITY OF TANAUAN )
AFFIDAVIT OF LOSS

I, ERIC LAGDAMEO DELA TORRE, 27 years old, single and a resident of Brgy.
4, Tanauan City, Batangas, after having been sworn to in accordance with law, hereby
depose and say THAT:

1. I applied and was granted a Student Permit with Land Transportation Office
(LTO), Lipa City field office;

2. I insert the said Student Permit inside my wallet together with the Pawn
Receipt issued by St. Paul Gadget Pawnshop with office located at Tanauan City,
Batangas

3. The said receipt of Pawnshop was issued because I pawned my OPPO X5s to
them last January 2020;

4. Both said Student Permit and Pawn Receipt were placed in my wallet for
easy reference and accessibility;

5. On February 23, 2020, upon arrival at home from my personal errands

that day, I looked the said wallet inserted in my pants pocket and had discovered it
was no longer there and might have fell off while traveling on a personal errands;

6. I exerted efforts to retrieve it in the place where I went on that day but to
no avail. Hence, I am certain that the aforesaid wallet bearing the Student Permit and
Pawn Receipt are now lost and beyond recovery;

7. The said Student Permit issued by the LTO Lipa City field office has
never been confiscated by any law enforcement agency or has no pending or
unresolved case for apprehension, alarm, suspension or revocation of person in
authority for cause;

6. I am executing this affidavit for purposes of attesting to the truth of the

foregoing fact that my Driver’s Student Permit was lost, to request the concerned office
for the issuance of new Driver’s Student Permit in lieu of the lost one AND for all any
other legal intents and purposes this affidavit may serve.

7. I am executing this affidavit to attest to the truthfulness and veracity of

the foregoing statements, for the purpose of requesting for issuance of new copy of the
subject Student Permit from LTO and Pawn Receipt from St. Paul pawnshop in lieu of
those lost and for whatever legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 24th day of February
2020 at Tanauan City, Batangas, Philippines.

ERIC LAGDAMEO DELA TORRE

Affiant

SUBSCRIBED AND SWORN to before me this 24th day of February 2020 at

Tanauan City, Batangas, Philippines, affiant exhibiting to me his Voter’s Certification
bearing his picture and signature to prove his identity.

HEART C. LERO
Public Attorney II
Pursuant to R.A. 9406