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Affidavit of Loss for Driver's License

1. Jose Rod M. Figueroa filed an affidavit of loss regarding his lost professional driver's license with license number L0491026454 and restrictions 1, 2, 3, and 8 issued by the Land Transportation Office (LTO). 2. He states that despite diligent search efforts, he was unable to find the lost license and believes it is lost beyond recovery. 3. He also states that the license was not confiscated by law enforcement for any traffic violations.

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gelbert palomar
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130 views1 page

Affidavit of Loss for Driver's License

1. Jose Rod M. Figueroa filed an affidavit of loss regarding his lost professional driver's license with license number L0491026454 and restrictions 1, 2, 3, and 8 issued by the Land Transportation Office (LTO). 2. He states that despite diligent search efforts, he was unable to find the lost license and believes it is lost beyond recovery. 3. He also states that the license was not confiscated by law enforcement for any traffic violations.

Uploaded by

gelbert palomar
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 Iloilo ) S.S.

AFFIDAVIT OF LOSS

I, JOSE ROD M. FIGUEROA, of legal age, married, Filipino and a resident of Brgy.
San Jose, Dingle, Iloilo, Philippines, after being sworn in accordance with law, depose and say:

1. That I am a holder of a Professional Driver’s License, with License No.


L0491026454, and with restrictions 1, 2, 3, 8, issued by the Land Transportation
Office (LTO);

2. That the said Driver’s License, with License No. L0491026454, with restrictions 1, 2,
3, 8 was lost and could not be found and that despite of diligent search and efforts, the
same could no longer be found, such that I now believe that it is now lost and beyond
recovery;

3. That the said Driver’s License, with License No. L0491026454, with restrictions 1, 2,
3, 8 has not been confiscated by the LTO, Police Officer, or other Traffic Enforcers
for any traffic violations;

4. That I am executing this affidavit of loss to attest to the truth of the foregoing and to
support my application for the issuance of the new Professional Driver’s License, leu
of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this _____day of ____________,


2022 in the City of Iloilo, Philippines.

JOSE ROD M.
FIGUEROA
Affiant

SUBSCRIBED AND SWORN to before me this ____ day of _____________, 2022, in the
City of Iloilo, Philippines. Affiant exhibiting to me his Identification Card Number
____________ issued on ______________ at _________________.

WITNESS MY HAND AND NOTARIAL SEAL on the day, year and place first above-
written.

Doc. No.______
Page No.______
Book No.______
Series of 2022

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