REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO ) S.s.

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

AFFIDAVIT OF LOSS

I, STEPHEN S. ESTREVENCION, single, Filipino, of legal age, widow, and a resident of

Barangay Balibagan, Igbaras, Iloilo, after having been duly sworn to in accordance with law, do
hereby depose and say that:

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

rules and regulations, and was issued a corresponding Driver’s License;

2. Sometime last week, said Driver’s License was misplaced and got lost;

3. Despite diligent search and efforts to locate my Driver’s License, I could not find the
same, such that I believe it is now lost beyond recovery;

4. That said Driver’s License has not been confiscated by the Land Transportation
Office, Philippine National Police or other Traffic Enforcers for any traffic violation
or infraction

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 Driver’s License, in
lieu of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 14th day of November at Iloilo
City, Philippines.

STEPHEN S. ESTREVENCION
Affiant
Voter’s ID No.

SUBSCRIBED AND SWORN to before me this November 15, 2023 at Iloilo City,
Philippines, affiant upon exhibiting to me his duly issued government ID with details stated above,
bearing his signature.

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