REPUBLIC OF THE PHILIPPINES)

Municipality of Cordova……………… ) S.S.

AFFIDAVIT OF LOSS

I, WENDA ALFANTA., Filipino, of legal age, and presently residing at Purok 7 Sambagan,
Dapitan, Cordova, Cebu, after having been sworn in accordance with law hereby depose
and state:

1. That I am the registered owner of Suzuki Pick-up Private Utility

Vehicle with Plate No. YBV856;

2. That sometime on July 31, 2023, while we were traversing the road
of Lapu-Lapu City along Marie Ernestine School, I noticed a heavy downpour
of rain went on causing the area to flood and most of the vehicles had
difficulty of passing through that area including the vehicle we drove during
that time, consequently after we arrived at home, I found out that the front
original plate number issued by LTO was already missing to where it was
attached to our vehicle;

3. That diligent efforts were exerted by me and my relatives to locate

the same, however it remained futile or the said original plate can no longer
be found until this time.

4. That I am executing this Affidavit to attest to the truth of the

foregoing and in support of my request for issuance of new plate number or
any purpose this affidavit could serve accordingly.

IN WITNESS WHEREOF, I have hereunto set my hand this ___day of August 2023, at
Cordova, Cebu, Philippines

WENDA ALFANTA
Affiant

SUBSCRIBED AND SWORN to before me, this _____ day of _______________, 2023 in
_________________________ with affiant exhibiting her Valid ID___________________________
issued by____________________________

Doc. No. ________;

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