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Affidavit of Loss

Herbert Gwapo, a resident of Quezon City, executed an Affidavit of Loss regarding his driver's license, which was misplaced after he surrendered it to a security guard at Quirino State University on March 24, 2022. Despite returning the next day to retrieve it, he was informed that the license could not be found. The affidavit is intended to support his application for a replacement of the lost license.

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Zyrra Paduaon
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22 views2 pages

Affidavit of Loss

Herbert Gwapo, a resident of Quezon City, executed an Affidavit of Loss regarding his driver's license, which was misplaced after he surrendered it to a security guard at Quirino State University on March 24, 2022. Despite returning the next day to retrieve it, he was informed that the license could not be found. The affidavit is intended to support his application for a replacement of the lost license.

Uploaded by

Zyrra Paduaon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

Name: Paduaon, Zyrra B.

Date: April 1, 2022


Year and Section: BScrim, 4-B Score:

Activity No. 1. Affidavit of Loss

REPUBLIC OF THE PHILIPPINES)


CITY OF QUEZON) S.S

AFFIDAVIT OF LOSS

I, HERBERT GWAPO, of legal age, Filipino, residing at 143 Zuzuaregui Street, Don
Antonio Heights, Quezon City under oath, hereby dispose and state that:

1. I am the holder of the driver’s license No. L02-10-003322 issued by the LTO Central
Office.

2. Sometimes on March 24, 2022, I entered our campus at Quirino State University and
surrendered my driver’s license to the security guard at the university gate. I went to the
registrar to enroll and afterwards I went to retrieve my driver’s license after enrolling.
However, the security guard who received my license was then elsewhere.

3. I returned the next day to get my license. Unfortunately, I was informed that my licensed
was misplaced. The security guard concerned could not anymore remember where he
had placed it.

4. I am executing this Affidavit to attest to the truth and veracity of the foregoing and to
support my application for a replacement of my lost driver’s license.

IN WITNESS WHEREOF, I have hereunto affixed my signature on the 25th day of March
2022 at Quezon City.

HERBERT GWAPO
Affiant

SUBSCRIBE AND SWORN, to before me in 25th day of March 2022, affiant have
exhibited to me his competent evidence of identity Postal ID No. 0919 issued by the
Philippine Post Office on 10th day of January, 2022.

ATTY. MARAG G. SAKSAK


Doc No: 25 Notary public
Page No: 6 UNTIL May 15, 2022
Book No: VI PRT No. 9511453 12-23-22
Series of 2022 IBP No. 150014 01-09-2022
ROLL No. 123456
TIN No. 560-345-234
MCLE Exemption No. VI 0013877
Until July 26,2022

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