I, __________, of legal age, Filipino, single, and a resident of
_______________________________, 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 NonProfessional Drivers License with Number _____________________; 2. Sometime on ______________, said Drivers License was misplaced and got lost; 3. Efforts were exerted to locate said Drivers License, but in spite of diligent search, it could not be found and the same is now beyond recovery; 4. Said Drivers License has not been confiscated by the LTO, Police or other Traffic Enforcers for any traffic violation; 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 NonProfessional Drivers License, in lieu of the one that was lost; IN WITNESS WHEREOF, I have hereunto set my hand this _________ in _______ City, Metro Manila, Philippines