REPUBLIC OF THE PHILLIPINES )

CITY OF MANDALUYONG ) S.S

X-----------------------------------------X

AFFIDAVIT OF LOSS

I, DANNA MAE S. ZERRUDO, Filipino, of legal age, single, and with address at 36
Libertad St., DMG Village, Mandaluyong City, after having been duly sworn to in accordance
with law, hereby depose and say that:

1. I was issued a Professional Driver’s License by the Land Transportation Office with
Driver’s License Number N07-21-101991, and with expiration date at 2022/05/30;

2. I used to keep said Driver’s License in my bag for safekeeping, however, around June
2, 2020, when I was in a Conference in DTI Main Office, said Driver’s License got
lost;

3. Despite diligent search and efforts to locate said Driver’s License, I could not find it;

4. In view of the foregoing, I am executing this document to attest to the truth of the
foregoing, for the replacement/reissuance of my Professional Driver’s License, and
for all other legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this 9th Day of October 2020 in
Mandaluyong City, Philippines.

DANNA MAE S. ZERRUDO

Affiant

SUBSCRIBED AND SWORN to before me this 9th Day of October 2020 in Mandaluyong City
Philippines, the affiant exhibiting her Passport No. P051097C issued by DFA Manila on February
05, 2020.

(Sgd). ATTY. GLADEE C. MONTALBO

Notary Public for Mandaluyong
Commission Serial No. 143
Until December 31, 2020
IBP No. 10721/Jan. 1, 2014/City of Mandaluyong
PTR No. 10199/Jan. 1, 2020/City of Mandaluyong

Doc. No.: 43;

Page No.: 8;
Book No.: V:
Series of: 2020