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Affidavit of Loss - Salgados

The document is an affidavit of loss filed by Reginald Joseph T. Salgados stating that his driver's license was lost on February 8, 2022 and requesting a new license be issued in place of the lost one.

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Agang Molina Columnas
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31 views1 page

Affidavit of Loss - Salgados

The document is an affidavit of loss filed by Reginald Joseph T. Salgados stating that his driver's license was lost on February 8, 2022 and requesting a new license be issued in place of the lost one.

Uploaded by

Agang Molina Columnas
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 Tagbilaran           ) S.S.

AFFIDAVIT OF LOSS

I, REGINALD JOSEPH T. SALGADOS, Filipino, of legal age, married,


and a resident of Catagbacan Sur, Loon, Bohol, Philippines, after being duly
sworn to in accordance with law, do hereby depose and state:

1. That I am a holder/owner and possessor of driver’s license which


was issued by LTO;

2. That on or about February 8, 2022, the above-mentioned driver’s


license was lost and its whereabouts cannot be ascertained despite
due and diligent search made and undertaken such that I now believe
that the same is lost beyond recovery;

3. That I now request the LTO to issue a new insurance policy in lieu
of the lost one and I bind myself to surrender the lost documents in
the event that the same is found and/or located;

4. That I covenant to indemnify the LTO for any loss and damage it
may incur by reason of its issuance or replacement;

5. That I am executing this affidavit to attest to the veracity of the


above-stated facts, for the purpose of the issuance of a new
insurance policy or any other legal purpose which this affidavit may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this


_______________ at Tagbilaran City, Philippines.

REGINALD JOSEPH T. SALGADOS


Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this __________ affiant


personally presented to me his competent and valid proof of identity.

Doc No: _____;


Page No: ____;
Book No: ____;
Series of: ____;

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