REPUBLIC OF THE PHILIPINES )

PROVINCE OF MASBATE ) S.S.

AFFIDAVIT OF LOSS
I, ISIDRO B. ABELITA, of legal age, Filipino, widower and with
residence address at Barangay Poblacion, Balud, Masbate, subscribing under
oath, depose and state:

1. I am a holder and/or possessor of a valid Driver’s License duly

issued by the Land Transportation Office (LTO).

2. I used to place said Driver’s License inside my wallet.

3. On 4 May 2022, I discovered that said Driver’s License was no

longer in my wallet where I placed it.

4. Diligent efforts to locate the same had proved futile.

5. I am executing this affidavit to attest to the truth of the

foregoing and for whatever legal purpose this may serve and in support for
my request for the replacement of said Driver’s License.

Affiant further sayeth naught.

Masbate City, Masbate, 20 May 2022.

ISIDRO B. ABELITA
Affiant

SUBSCRIBED AND SWORN to before me this 20th day of May

2022, in Masbate City, Masbate, by affiant who is personally known to me.

Doc. No._____;
Page No._____;
Book No._____;
Series of 2022.