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Loss Sample

The affiant lost their professional driver's license that was confiscated by an LTO officer on September 12, 2019. Efforts to locate the lost license were unsuccessful. As such, the affiant filed an affidavit of loss to support their application for a new driver's license to replace the one that was lost unintentionally by the LTO officer. The affiant attested to the truth of the statements made in the affidavit, which was sworn to on September 13, 2019 in Paniqui, Tarlac, Philippines.

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Wilson Manalang
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44 views1 page

Loss Sample

The affiant lost their professional driver's license that was confiscated by an LTO officer on September 12, 2019. Efforts to locate the lost license were unsuccessful. As such, the affiant filed an affidavit of loss to support their application for a new driver's license to replace the one that was lost unintentionally by the LTO officer. The affiant attested to the truth of the statements made in the affidavit, which was sworn to on September 13, 2019 in Paniqui, Tarlac, Philippines.

Uploaded by

Wilson Manalang
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)

PROVINCE OF TARLAC ) S.S.


MUNICIPALITY OF PANIQUI )
x----------------------------x

AFFIDAVIT OF LOSS

I, __________________ of legal age, Filipino and a resident at


__________________________, 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 Professional Driver's License with License No.
_____________________ which is valid until ___________________;

2. Sometime on September 12, 2019 the said driver's license was been
confiscated by the LTO Officer;

3. On September 12, 2019 at around 3:30pm, when I was about to claim


the said Driver’s License, it was unintentionally misplaced/lost by the LTO
Officer;

4. 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;

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
Professional Driver's License, in lieu of the one that was lost;

IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of


September 2019 Paniqui, Tarlac, Philippines.

_________________________.
Affiant

SUBCRIBED AND SWORN TO before me this 13th day of September 2019


Paniqui, Tarlac, Philippines.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2019.

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