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REPUBLIC OF THE PHILIPPINES)

Quezon City ) S.S.

AFFIDAVIT OF LOSS

I, ROGER ESTRADA, of legal age, Filipino and with postal address at


Sta. Maria St., Brgy. Duquit, Mabalacat, Pampanga; after having been duly
sworn to in accordance with law do hereby depose and state-THAT:

1. I was issued a driver’s license ID card by the LTO and which will expire
on 2012;
2. I always keep my said ID in my wallet for convenience;
3. Sometime on 23 October 2010 at around 8:00AM I was driving a
company vehicle along Roxas Boulevard when a man in uniform
signaled me to halt from driving. He approached me while I was at the
driver’s seat and he introduced himself as MMDA officer and he was
charging me of Swerving; he instructed me to surrender my driver’s
license and without hesitation I handed him my said license;
4. Few seconds after, the said MMDA officer swiftly left with his motor
vehicle; I was shocked and I didn’t know what to do then, not after a
few minutes, I realized that I have given my ID to a person whom I
wasn’t sure if he is indeed a MMDA officer;
5. I went to the municipal office of Manila to check if my License was
reported or turned over but to no avail. Likewise, I went to LTO but the
same was proven vain;
6. I exerted diligent effort in locating my said license but the same could
not be found and should therefore be considered lost;

As such, I am executing this Affidavit of Loss to attest to the truth of


the foregoing and as compliance to LTO’s requirement for my application for
issuance of replacement of my lost Driver’s License ID Card.

AFFIANT FURTHER SAYETH NAUGHT.

ROGER ESTRADA
Affiant
__________ ID card No. ____________

SUBSCRIBED AND SWORN to before me this 25th of November 2010 at


Quezon City, affiant exhibiting to me his competent evidence of identity as
shown above.

Atty. MIGUEL C. INOCENCIO, JR.


Doc. No. ___________ ; NOTARY PUBLIC
Page No. ___________ ; UNTIL DECEMBER 31, 2011
PTR NO. 3497759/01-08-10/CALOOCAN
Book No.___________ ; IBP NO. 779991/01-05-10/CALOOCAN
Series of 2010. ROLL NO. 57269