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Affidavit of Loss (Driver's License)

This affidavit of loss was submitted by an individual to attest that their driver's license was lost. The 3-page document details that the individual was a licensed driver issued a license that is now expired. They state that the license was misplaced and despite searching, they were unable to find it and believe it is lost. The individual signs the affidavit to support their application for a new license to replace the lost one. They provide their identification details and the affidavit is notarized.

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april
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155 views1 page

Affidavit of Loss (Driver's License)

This affidavit of loss was submitted by an individual to attest that their driver's license was lost. The 3-page document details that the individual was a licensed driver issued a license that is now expired. They state that the license was misplaced and despite searching, they were unable to find it and believe it is lost. The individual signs the affidavit to support their application for a new license to replace the lost one. They provide their identification details and the affidavit is notarized.

Uploaded by

april
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
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Republic of the Philippines)

City of ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, ___________________________, of legal age, Filipino, single/married, and a resident


of
_____________________________, after having been sworn in accordance with law,
hereby deposes and states the following:

1. That I am a duly-licensed driver in accordance with pertinent Land


Transportation laws, rules and regulations, and was issued a corresponding
Driver's License with number _______ which is valid until __________;

2. That last (date), the said Driver's License was misplaced and got lost. That
despite diligent search and efforts to locate my Driver's License, I could not find
the same such that I now believe that it is now lost beyond recovery;

3. That said Driver's License has not been confiscated by the LTO, Police or other
Traffic Enforcers for any traffic violation.

4. 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
Driver's License, in lieu of the one that was lost.

Signed on the date and at the place indicated below.

(Name and signature)


Affiant

Competent Evidence of Identity


ID: PRC license
issued on: 7/7/2017
at: Sampaloc, Manila

SUBSCRIBED and SWORN TO before me on the date and at the place indicated
below. The affiant exhibited to me his competent evidence of identity as indicated above.

Signed this ______________at ________________, ______________________,


Philippines.

WITNESS MY HAND AND SEAL.


Notary Public

Doc. No.
Page No.
Book No. I
Series of

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