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Sample Affidavit of Loss of Driver's License

Affidavit Affidavit of Loss



REPUBLIC OF THE PHILIPPINES)
CITY OF MAKATI            ) 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 ManilaPhilippines.





____________________
Affiant
SSS ID No. _____________


 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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