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Affidavit of Loss

Bryant Paul Romero Valentino, a resident of Roxas, Isabela, has lost his driver's license on April 10, 2025, and has made diligent efforts to locate it without success. He states that the license was never given to anyone and was not confiscated by authorities. This affidavit is executed to attest to the loss and to secure a replacement license.

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16 views1 page

Affidavit of Loss

Bryant Paul Romero Valentino, a resident of Roxas, Isabela, has lost his driver's license on April 10, 2025, and has made diligent efforts to locate it without success. He states that the license was never given to anyone and was not confiscated by authorities. This affidavit is executed to attest to the loss and to secure a replacement license.

Uploaded by

drmyrven
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

MUNICIPALITY OF ROXAS.

AFFIDDAVIT OF LOSS

I, BRYANT PAUL ROMERO VALENTINO, of legal age, Filipino, single, and


resident of 29D Claro M. Recto St., Purok 4 Barangay. Rizal, Roxas, Isabela, REGION 2, after
having been duly sworn to in accordance with the law hereby depose and say:

1. I am holder of a Drivers License issued at LTO, Roxas, Isabela;

2. The said Drivers License was lost sometime on April 10, 2025, my pocket containing
my drivers license was lost, I don’t know if it was taken by unidentified person or it
just slipped out from my pocket or misplaced it. I exerted diligent effort to locate the
said Drivers License but the same could no longer be found; hence, considered
forever lost;

3. Said DRIVERS LICENSE was never given nor pledged to anyone for any purpose
whatsoever, nor it was taken or confiscated by the authorities for any violation of the
law;

4. I am executing this affidavit to attest to the veracity and truthfulness of my foregoing


statements and for the purpose of securing a new DRIVERS LICENSE in lieu of the
lost one and for other lawful intent and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this


_____________________________ at ___________________________.

BRYANT PAUL ROMERO VALENTINO


Affiant

SUBSCRIBED AND SWORN, to before me this ______________________ at


________________________, Philippines. Affiant is personally appeared before me and the
same person who executed this instrument freely and willingly.

Witness my hand and seal this ________________________ 2025.

Doc. No.
Page No.
Book No.
Series of 2025

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