REPUBLIC OF THE PHILIPPINES )

……………………………………………..)
x--------------------x

AFFIDAVIT OF LOSS OF LICENSE

I, AAA, a Filipino citizen, of legal age, single, and a resident of

___________________, having been duly sworn in accordance with law, do
hereby depose and state:

1. That I was issued a LTO DRIVERS LICENSE;

2. That sometime around August 2022, when I looked for the said
DRIVERS LICENSE where I normally place it, I could no longer find
the same;

3. That despite diligent search and efforts to locate the foregoing

DRIVERS LICENSE, I could not find the same such that I now believe
that it is now lost beyond recovery;

4. That as such, I am executing this Affidavit of Loss to attest to the

truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hand this

______________, 2022 at ___________________, Philippines.

AAA
Affiant
I.D No. ____________

SUBSCRIBED AND SWORN to before me, a Notary Public in

_____________, this _________________, in ___________________, by the
Affiant who presented to me her competent evidence of identity.

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