REPUBLIC OF THE PHILIPPINES)

CITY OF DAVAO ) S.S.

x----------------------------x

AFFIDAVIT OF LOSS

I, Azeneth Josol, of legal age, Filipino, married and a resident of One

Oasis Condominium, Ecowest Drive, Drive Davao City, after having been
duly sworn to in accordance with law, depose and state THAT:

1. I am a duly-licensed driver in accordance with pertinent Land

Transportation laws, rules and regulations, and was issued a
corresponding (Non) Professional Driver's License with number M06—
18-000578 which is valid until August 27, 2023;

2. Sometime on February 1, 2023, said driver's license was misplaced and

got lost;

3. Due efforts were exerted to locate said driver's license, but in spite of
diligent search, it could not be found and the same is now beyond
recovery;

4. Said Driver's License has not been confiscated by the LTO, Police or other
Traffic Enforcers for any traffic violation;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the

foregoing and to support my application for the issuance of a new (Non)
Professional Driver's License, in lieu of the one that was lost;

IN WITNESS WHEREOF, I have hereunto set my hand

this February 14, 2023 in Davao City, Philippines.

Azeneth Josol
Affiant
SSS ID No. 14344000

SUBCRIBED AND SWORN TO before me this February 14, 2023 in

Davao City, Philippines, affiant exhibiting to me his/her competent
evidence of identity by way of presenting SSS ID No. 14344000 issued at
Davao City on August 27, 2018.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023.