AFFIDAVIT OF LOSS

That I, Reena Rizza P. Ocampo, of legal age, single, Filipino, with resident address
at Blk. 9 Lot 23 Villa Zaragosa Subd., Brgy. Turo, Bocaue Bulacan, after having duly sworn
to in accordance with law hereby depose and say;

That I am the Owner of Driver’s License No. N25-18-008224 issued by LTO

Caloocan Licensing Extension Office which will be expired on July 27, 2022.

That last week, between February 14 to 18, 2022, upon processing the business
permit of the company, the said original Driver’s License was found to be lost;

That the above-mentioned original Identification Card was misplaced and that
diligent effort to locate the same up to present proved futile.

That I am executing this affidavit of loss to attest to the fact of the lost of the
aforesaid original Driver’s License ID and for the purpose of Renewal of Driver’s License
in LTO.

IN WITNESS WHEREOF, I have hereunto set my hand this 21 st day of February,

2022.

Reena Rizza Ocampo

Affiant

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES

QUEZON CITY, PHILIPPINES

Before me a NOTARY PUBLIC for and in Quezon City personally appeared the affi-
ant exhibiting to me her Passport # P1966896B issued by DFA NCR West issued on June
15, 2019.

Witness my hand and seal in the place and date written below.

Doc. No.:
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