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Affidavit of Loss

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93 views2 pages

Affidavit of Loss

Uploaded by

Anonymous KZEIDzYrO
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC 

OF THE PHILIPPINES)
CITY OF MAKATI            ) S.S.
x----------------------------x
  

AFFIDAVIT OF LOSS

 I, ___________________, of legal age, Filipino, (single/married/widow)


and a resident of _______________________________, after having been
duly sworn to in accordance with law, depose and state THAT:

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


laws, rules and regulations, and was issued a corresponding (Non)
Professional Driver's License with number _____________ which is valid
until _____________;

2. Sometime on ____________, said driver's license was misplaced and got


lost;

3. Efforts were exerted to locate said driver's license, but in spite


of diligent search, it could not be found and the same is now beyond
recovery;

4. Said Driver's License has not been confiscated by the LTO, Police or other
Traffic Enforcers for any traffic violation;

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 (Non)
Professional Driver's License, in lieu of the one that was lost;

IN WITNESS WHEREOF, I have hereunto set my hand


this ___________________ in Makati City, Metro Manila, Philippines.

_________________

Affiant

SSS ID No. _________


 SUBCRIBED AND SWORN TO before me
this ___________________ in _________________, Philippines, affiant
exhibiting to me his/her competent evidence of identity by way of
__________________ issued at ______________
on __________________.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2013.

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