Republic of the Philippines}

Province of Cotabato }s.s

Kidapawan City }
x-------------------------------------x

AFFIDAVIT OF LOSS
I, BENJAMIN AJAO CABISADA of legal age, Filipino, single and a
resident of Manongol, Kidapawan City, North Cotabato after having been duly
sworn to in accordance with law, do hereby depose and say;

That I am the holder of PROFESSIONAL DRIVER’S LICENSE issued at

LTO, Kidapawan City, Cotabato;

That on March 20, 2022 the aforementioned PROFESSIONAL DRIVER’S

LICENSE was lost in my possession somewhere in Kidapawan City, North
Cotabato;

That despite of my earnest efforts to locate the same but proved futile, hence
aforementioned PROFESSIONAL DRIVER’S LICENSE was now considered
lost and beyond recovery;

That I am executing this statement to attest to the truthfulness and veracity

of the foregoing facts to request LTO Office to issue another Professional Driver’s
License in lieu of the one lost and for whatever legal intent and purposes which
may serve best.

IN WITNESS WHEREOF, I have hereunto set my hand below this 24th day of
March 2022 at Kidapawan City, Philippines.

BENJAMIN AJAO CABISADA

Affiant
OSCA ID No. 4782

SUBSCRIBED AND SWORN to before me this 24th day of March 2022 at Kidapawan
City, Cotabato, Philippines. Affiant exhibited to his Identification Card Number indicated below
his name.

ATTY. OSCAR D. BAYOG

Doc. No. 69 Notary Public

Page No. 14 Until December 31, 2022

Roll No.18081
Book No. 05 IBP Life Time Member
IBP OR No. 1009201/9-4-2015
Series of 2022 O.R. No. 1012991/12-15-2015
PTR No. 2489090/01-10-2022
MCLE Compliance No. VI-0013914:Valid until April 14,2022
2/F GSP Building, Quirino Drive, Kidapawan City
Notarial Com.No 132-2019