REPUBLIC OF THE PHILIPPINES}

Tubod, Lanao del Norte } Sc.

AFFIDAVIT OF LOSS

I, Louwella Erediano-Ibabao, Filipino citizen, of legal age, married to Ian S. Ibabao and a
resident of Purok 1, San Antonio, Tubod, Lanao del Norte, after having sworn to in accordance
with law hereby deposes and states that;

1. I am a verified holder of a Driver’s License with License No. K-16-20-000886 to expire

on October 18, 2024.

2. I have recently discovered the said item is irretrievably lost and can no longer be found
despite diligent efforts to locate the same.

3. I execute this affidavit to attest the truth of the foregoing statement and for whatever legal
intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 4th day of April, 2023 in
Tubod, Lanao del Norte, Philippines.

LOUWELLA E. IBABAO
Affiant

SUBSCRIBED AND SWORN TO before me this 4th day of April, 2023 in Tubod, Lanao del
Norte, Philippines, affiant exhibiting to me her/his competent proof of identity.