Scribd
Upload
96 views1 page

Affidavit of Loss: Rachil Cabusas Tolentino

Rachil Cabusas Tolentino lost her driver's license on July 9, 2020 while at the Poblacion Public Market in Prosperidad, Agusan del Sur in the Philippines. She reported the lost license to the local police station but was unable to find it. She is swearing in an affidavit that she is the rightful owner of the lost license and is requesting a replacement be issued since she has no other option after her efforts to locate the original failed. The affidavit was signed on July 30, 2020 in Patin-ay, Prosperidad, Agusan del Sur to attest to the truth of the statements made regarding the lost driver's license.

Uploaded by

Marceliano Monato III
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
96 views1 page

Affidavit of Loss: Rachil Cabusas Tolentino

Rachil Cabusas Tolentino lost her driver's license on July 9, 2020 while at the Poblacion Public Market in Prosperidad, Agusan del Sur in the Philippines. She reported the lost license to the local police station but was unable to find it. She is swearing in an affidavit that she is the rightful owner of the lost license and is requesting a replacement be issued since she has no other option after her efforts to locate the original failed. The affidavit was signed on July 30, 2020 in Patin-ay, Prosperidad, Agusan del Sur to attest to the truth of the statements made regarding the lost driver's license.

Uploaded by

Marceliano Monato III
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
You are on page 1/ 1

REPUBLIC OF THE PHILIPPINES)

Province of Agusan del Sur ) S.S.


Municipality of Prosperidad )
x-----------------------x

AFFIDAVIT OF LOSS

I, RACHIL CABUSAS TOLENTINO Filipino, of legal age, and a resident of Brgy.


Poblacion, Prosperidad, Agusan del Sur, after having been sworn in accordance with law,
hereby depose and state THAT:

1. That I am the same person executing this Affidavit;

2. I am a holder of LTO Driver’s License.

3. Sometime in July 9, 2020, while I was at Poblacion Public Market, unconsciously I dropped my
wallet containing the original copy of such Drivers License ID;

4. I exercised due diligence in locating the said ID Card and have reported its loss to the Police
Station in Poblacion, Prosperidad, Agusan del Sur;

5. My efforts to locate my Driver’s License and Voters ID have failed since until now the same has
not been found, leaving me with no other recourse but to request and process for the issuance of a
replacement thereof, for which purpose this affidavit is executed; and

6. I attest to the truth of the foregoing statements.

IN WITNESS WHEREOF, I hereunto affix my signature this 30th day of July 2020 at Patin-ay,
Prosperidad, Agusan del Sur, Philippines.
 

RACHIL CABUSAS TOLENTINO


Affiant
VIN 0305-0037A-H0980RCT-10000

SUBSCRIBED AND SWORN to before me, this 30th day of July 2020 at Patin-ay,
Prosperidad, Agusan del Sur, Philippines.

You might also like