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Affidavit of Closure

The document is an affidavit of loss filed by an individual who lost their driver's license. In the affidavit, the individual attests that (1) they are a licensed driver who was issued a license that has since expired, (2) the license was misplaced and lost on a specific date despite efforts to find it, (3) the license has not been confiscated by authorities, and (4) the affidavit is being filed to support an application for a new license to replace the lost one. The affidavit is signed and notarized.

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JM Camalon
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127 views1 page

Affidavit of Closure

The document is an affidavit of loss filed by an individual who lost their driver's license. In the affidavit, the individual attests that (1) they are a licensed driver who was issued a license that has since expired, (2) the license was misplaced and lost on a specific date despite efforts to find it, (3) the license has not been confiscated by authorities, and (4) the affidavit is being filed to support an application for a new license to replace the lost one. The affidavit is signed and notarized.

Uploaded by

JM Camalon
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 BACOLOD ) S.S.


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

AFFIDAVIT OF LOSS

I, ___________________, of legal age, Filipino, (single/married/widow)


and a resident of _______________________________, after having been
duly sworn to in accordance with law, 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
_____________ which is valid until _____________;

2. Sometime on ____________, said driver's license was misplaced and


got lost;

3. Efforts were exerted to locate said driver's license, but in spite


of diligent search, it could not be found and the same is now beyond
recovery;

4. Said Driver's License has not been confiscated by the LTO, Police or
other Traffic Enforcers for any traffic violation;

5. As such, I am executing this Affidavit of Loss to attest to the truth of


the foregoing and to support my application for the issuance of a new
(Non) Professional Driver's License, in lieu of the one that was lost;

IN WITNESS WHEREOF, I have hereunto set my hand


this ___________________ in Makati City, Metro Manila, Philippines.

______________________

Affiant

SUBCRIBED AND SWORN TO before me this


___________________ in _________________, Philippines, affiant
exhibiting to me his/her competent evidence of identity by way of
__________________ issued at ______________ on __________________.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2013

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