Republic of the Philippines)

City of Cebu……………….) S.c.

AFFIDAVIT OF LOSS

I, JONATHAN F DACUA, of legal age, Filipino, married and a

resident Brgy. 1, Poblacion, Tuburan, Cebu, after having been duly
sworn to in accordance with law, do hereby depose and state that—

1. On June 30, 2022, I and my kid went to the house of my friend

because we were invited to attend a birthday celebration;

2. Since I was using my motorcycle, I just brought with me my

wallet where I placed my money and my other pertinent
documents, including my Driver’s License Card;

3. The following day, I went to Palawan Express in order to claim

money; however, when I was asked to present my identification
card, I noticed that my Driver’s License Card was no longer
inside my wallet;

4. I exerted all efforts in order to locate the same but all proved
futile;

5. I am declaring the same to have been lost for all intents and
purposes;

6. I am executing this affidavit to attest the truthfulness of the

foregoing and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this 13th day of July 2022 in the City of Cebu, Philippines.

JONATHAN F DACUA
Affiant
DL No. (as per OR) G05-13-001644
Expires on June 25, 2023

SUBSCRIBED AND SWORN TO before me this 13th day of July

2022 in the City of Cebu, Philippines.

Doc. No. __
Page No. __
Book No. __
Series of 2022