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Affidavit of Loss for Plate Card

Ella J. Milallos filed an affidavit of loss stating that she is the store manager of MotorJoy Depot in Sto. Tomas, Davao del Norte and is the lawful holder of a plate card registered to Ronnie Lopes Alcano for a certain vehicle. She diligently tried to locate the lost plate card but was unable to find it. She attests that the plate was not lent to anyone else and was not confiscated. She will accept any administrative fines or penalties if found responsible for unauthorized use of the lost plate. The purpose of the affidavit is to secure a replacement for the lost plate card.

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246 views1 page

Affidavit of Loss for Plate Card

Ella J. Milallos filed an affidavit of loss stating that she is the store manager of MotorJoy Depot in Sto. Tomas, Davao del Norte and is the lawful holder of a plate card registered to Ronnie Lopes Alcano for a certain vehicle. She diligently tried to locate the lost plate card but was unable to find it. She attests that the plate was not lent to anyone else and was not confiscated. She will accept any administrative fines or penalties if found responsible for unauthorized use of the lost plate. The purpose of the affidavit is to secure a replacement for the lost plate card.

Uploaded by

JinJiShin
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 )

MUNICIPALITY OF SANTO TOMAS ) S.S.


Province of Davao del Norte )
x--------------------------------------------x

AFFIDAVIT OF LOSS
I, ELLA J. MILALLOS, of legal age, Filipino, single, and a resident of Purok 1A,
Feeder Road #1, Brgy. Tibal-og, Sto. Tomas, Davao del Norte, Philippines, after having been
sworn to in accordance with law, do hereby depose and state that:

1. I am the same affiant who personally and voluntarily caused the preparation and
execution of this affidavit;

2. I am the Store Manager of MOTORJOY DEPOT, INC. (MOTORTRADE) - Sto.


Tomas branch, Davao del Norte, Philippines;

3. Likewise, I am a lawful holder of a Plate card bearing the number LA14376 which
was registered under the name of Ronnie Lopes Alcano, for a certain motor vehicle
bearing the M.V. File No. 1136-00000151149, Engine No. G420ID975027, Chassis
No. BG41D412957;

4. Upon discovery of the lost plate, I diligently tried to locate it but all efforts exerted
proved futile and to no avail. Hence, the same is considered as permanently lost or
stolen and beyond recovery;

5. The lost plate was never lent to another person or entity nor confiscated by any
other law enforcement agency;

6. If the DOTC through the LTO/LTFRB, after inquiry, had found me responsible for
the unauthorized use of the herein reported lost plate, I hereby signify my
conformity to be meted the administrative fines and penalties due and imposed
thereon, including the grounding of unit/s covered by the Certificate of the Public
Convenience issued therefore, with waiver and desistance on my part for any
claim or action by reason of the aforesaid punitive measures taken against me;

7. Purpose of the Affidavit of Loss:

[ ] For LTFRB Petition for Dropping and Substitution


[ ] For LTFRB Petition for Sale and Transfer, and/or
[X] For securing a replacement of the lost plate card

8. I am executing this affidavit for the aforesaid purpose as well as for attesting to
the truth of the statements herein declared, subject to the rules on perjury.

IN WITNESS WHEREOF, I have hereunto set my hand this October 12, 2019 at Sto.
Tomas, Davao del Norte, Philippines.

ELLA J. MILALLOS
Affiant

SUBSCRIBED AND SWORN to before me this October 12, 2019 at Sto. Tomas,
Davao del Norte, Philippines.

Doc. No. 182;


Page No. 37;
Book No. 240;
Series of 2019.

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