Scribd
Upload
164 views2 pages

Affidavit of Loss

Mark Ryan V. Mendoza filed an Affidavit of Loss to report that his driver's license was misplaced and lost on January 25, 2017 after diligent search efforts. As the license has not been confiscated by authorities, Mendoza is executing the affidavit to support his application for a new driver's license to replace the lost one. The affidavit was sworn before a notary in Laoag City, Ilocos Norte, Philippines.

Uploaded by

Mark Ryan Visaya Mendoza
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
164 views2 pages

Affidavit of Loss

Mark Ryan V. Mendoza filed an Affidavit of Loss to report that his driver's license was misplaced and lost on January 25, 2017 after diligent search efforts. As the license has not been confiscated by authorities, Mendoza is executing the affidavit to support his application for a new driver's license to replace the lost one. The affidavit was sworn before a notary in Laoag City, Ilocos Norte, Philippines.

Uploaded by

Mark Ryan Visaya Mendoza
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

REPUBLIC OF THE PHILIPPINES)

CITY OF Laoag City

) S.S.

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

AFFIDAVIT OF LOSS
I, Mark Ryan V. Mendoza, of legal age, Filipino, single and a resident of #35 Pipias
Bacarra Ilocos Norte 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

corresponding

(Non)

Professional

Driver's

License

with number _____________ which is valid until 2017;


2. Sometime on Jan.25, 2017, 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,

have

hereunto

set

this ___________________ in Laoag City, Ilocos Norte, Philippines.

MARK RYAN V. MENDOZA


Affiant
SSS ID No. _____________

my

hand

SUBCRIBED

AND

SWORN

TO before

me

this ___________________ in

_________________, Philippines, affiant exhibiting to me his/her competent evidence of


identity

by

way

of

on __________________.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2013.

__________________

issued

at

______________

You might also like