Republic of the Philippines )

Province of La Union )S.S.

Municipality of Naguilian )
x----------------- --x

AFFIDAVIT OF LOSS
I, ALBERT C. SORIANO, Filipino, of legal age, married and a resident of Barangay
Mamat-ing Sur, Naguilian, Philippines, after being duly sworn to in accordance with law, hereby
depose and state:

1. That I am a duly-licensed driver in accordance with pertinent Land Transportation

laws, rules and regulations, and was issued a corresponding Driver's License;

2. That I kept such driver’s license with me for safekeeping;

3. That on March 20, 2020 at around 11:00 o’clock in the morning while I was on board
my tricycle on my way to Barangay Mamat-ing Sur, Naguilian, La Union, my wallet
must have dropped from where I kept it and got lost;

4. That said wallet contains my Driver’s License, Voter’s ID, Cebuana Membership ID,
Western Union membership ID and Official receipt from Addessa;

5. That despite diligent search and efforts to locate my Driver's License, I could not find
the same such that I now believe that it is now lost beyond recovery;

6. That said Driver's License has not been confiscated by the LTO, Police or other
Traffic Enforcers for any traffic violation;

7. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support my application for the issuance of the above-mentioned Driver’s
License in lieu of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th day of May 2020 at
Naguilian, La Union, Philippines.

ALBERT C. SORIANO
Affiant

SUBSCRIBED AND SWORN to before me this 18th day of May 2020 at Naguilian, La
Union, Philippines.