Republic of the Philippines )
City of Bacoor, Cavite ) s.s.
x-------------------------------------x
AFFIDAVIT OF LOSS
I, ______________________, of legal age, single, Filipino citizen, and a
resident of_______________________________, after having duly sworn to
in accordance with law, do hereby depose and state that:
1. Sometime in December 2018, I was looking for my Driver’s
License;
2. I have looked everywhere to find my it but it was nowhere to be
found;
3. Diligent efforts to locate the same was exerted but it proved futile;
4. I am executing this affidavit to attest to the truthfulness of the
foregoing facts and for what legal intents and purposes it may
serve.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREOF, I hereby affix my signature on this ___ day
of April 2019 in the City of Manila.
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME on this
__________________ in the City of ____________. Affiant exhibiting to me
his__________________________, bearing his photograph and signature
and avowed the truthfulness of the foregoing declarations.
Doc. No. : _____
Page No. : _____
Book No. : _____
Series of : 2019