Republic of the Philippines)

Province of  Cavite ) S.S.

Municipality of Alfonso ) 

AFFIDAVIT OF LOSS
I, JOLO FRANCO A. MOJICA, Filipino, of legal age, with present address at
Guyam, Indang Cavite, after being duly sworn to in accordance with law, hereby
depose and state, That;

1. I am in possession of a Non-Professional Driver’s License ID card issued by

Land Transportation Office (LTO);

2. However, upon checking my files, I found out just recently that said Driver’s
License was misplaced and cannot be found;

3. Despite diligent search and efforts to recover the said Driver’s License card, I
could not find the same such that I now believe that it is now lost beyond
recovery;

4. My Driver's License has not been confiscated by the LTO, Police or other Traffic
Enforcers for any traffic violation.

5. I am executing this affidavit not for any unlawful purpose but for any valid and
legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 31st day of January,
2020 at Province of Cavite, Philippines.

JOLO FRANCO A. MOJICA

Affiant

SUBSCRIBED AND SWORN to before me this 31st day of January, 220 at

Alfonso, Cavite. Affiant exhibiting to me his TIN: 322-273-565.

WITNESS MY HAND AND SEAL.

Doc. No. 151;

Page No. 31 ;
Book No. LXXVII ;
Series of 2020.