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Affidavit of Loss for Driver's License

Isaiah Caesar Gabuya Escolano filed an affidavit of loss stating that (1) he is a licensed driver issued license number H0518003290 valid until 2023, (2) he discovered his license was missing from his wallet on March 10, 2019 after arriving home from school, and (3) despite searching, he was unable to find the lost license and is requesting a replacement from the LTO.

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Chen C Abrea
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101 views1 page

Affidavit of Loss for Driver's License

Isaiah Caesar Gabuya Escolano filed an affidavit of loss stating that (1) he is a licensed driver issued license number H0518003290 valid until 2023, (2) he discovered his license was missing from his wallet on March 10, 2019 after arriving home from school, and (3) despite searching, he was unable to find the lost license and is requesting a replacement from the LTO.

Uploaded by

Chen C Abrea
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)

Province of Southern Leyte )


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

AFFIDAVIT OF LOSS

          I, ISAIAH CAESAR GABUYA ESCOLANO, of legal age, single, Filipino citizen and a
resident of Brgy. Bogo, Tomas Oppus, Southern Leyte, Philippines, after having been duly
sworn to in accordance with law, hereby 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 H0518003290 which is valid until January 8, 2023;

2. Sometime March 10, 2019, when I arrived home after school, I discovered that my
driver’s license was no longer in my wallet where I used to place it;

3. Despite diligent search and efforts to locate said driver’s license, I could not find it;

4. That said driver’s license was not confiscated by the authorities by reason of any
violation of existing rules and regulations;

5. That I am executing this affidavit to attest to the truth of the foregoing facts and to
request for a replacement of my driver’s license from the LTO.

IN WITNESS WHEREOF, we have hereunto set my hand


this ___________________ in Tomas Oppus, Southern Leyte, Philippines.

ISAIAH CAESAR GABUYA ESCOLANO


Affiant
ID: Driver’s License H0518003290
Issued by: LTO

   SUBCRIBED AND SWORN TO before me this ___________________ in Tomas Oppus,


Southern Leyte, Philippines, affiants exhibiting to me her valid proof of identification.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2018.

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