REPUBLIC OF THE PHILIPPINES )

DASMARIÑAS CITY, CAVITE )S.S.

AFFIDAVIT OF LOSS
(RE: DRIVER’S LICENSE)
I, SHERWIN MARTINEZ PADILLA, of legal age, Filipino Citizen, married, and with
postal and residence address at 107 Malagasang II-E Imus, Cavite, after having been duly sworn
to in accordance with law, hereby depose and say:

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;

That the said driver’s license was lost sometime on July 2022, due to it was inserted to
my wallet and unfortunately, the said wallet was unknowingly dropped somewhere and
considered as lost;

That despite of diligent efforts to locate the said ATM Card, the same cannot be
found/retrieved and considered as lost;

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

That I am executing this affidavit to attest to the truth of the foregoing facts for all legal
intents and purposes to support for the application for the issuance of a new Driver’s
license .

IN WITNESS WHEREOF, I have hereunto set my hand this 19th day of August 2022 at
Dasmarinas City, Cavite, Philippines.

SHERWIN MARTINEZ PADILLA

Affiant

SUBSCRIBED and SWORN to before me on the date and place above-written, affiant
exhibiting to me his/her VIN: 2106-0253A-F2382SMP10001-9

Doc. No. 405

Page No. 81
Book No. 15
Series of 2022