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Affidavit of Loss: I, - , of Legal Age, Filipino, (Single/married/widow)

This affidavit of loss was sworn by an individual who lost their driver's license. It details that the individual was a licensed driver issued license number [NUMBER] that was valid until [DATE]. The license was misplaced and lost on [DATE] despite diligent search efforts. The license has not been confiscated and this affidavit is being filed to support an application for a new license to replace the lost one. The affidavit was sworn on [DATE] in [CITY].

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193 views1 page

Affidavit of Loss: I, - , of Legal Age, Filipino, (Single/married/widow)

This affidavit of loss was sworn by an individual who lost their driver's license. It details that the individual was a licensed driver issued license number [NUMBER] that was valid until [DATE]. The license was misplaced and lost on [DATE] despite diligent search efforts. The license has not been confiscated and this affidavit is being filed to support an application for a new license to replace the lost one. The affidavit was sworn on [DATE] in [CITY].

Uploaded by

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

CITY OF ___________ ) 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. _____________

SUBSCRIBED 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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