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REPUBLIC OF THE PHILIPPINES) )S.S.

DONE: BAGUIO CITY ) X-----------------------X

AFFIDAVIT OF LOSS OF DRIVERS LICENSE I, LALA KARLA NAWALA, of legal age, single, Filipino, and with residence and postal address at No. 303 Gibraltar Road, Baguio City, after having been duly sworn to in accordance with law, hereby depose and state: 1. That I am a holder of a Drivers license with license number A01-94-059028 issued by the Land Transportation Office (LTO) of Baguio City; That on the 8th of December, 2008, I went shopping at the Center Mall, Baguio City and I noticed that my Drivers license was missing when I was about to pay my bill; That I tried to look for my drivers license with my all earnest efforts but despite diligent efforts to locate or retrieve the said license, the same proved futile and in vain; That I have waited from yesterday up to the present to see if somebody might have found it and to surrender the same to me, but up to this date, nothing had been surrendered, hence, I now consider the aforementioned drivers license lost and beyond recovery; That the aforesaid license have never been confiscated by, forfeited, surrendered or transferred to any person or entity, nor used for any unlawful purposes; That I am executing this affidavit for all legal intents and purposes it may serve, and to request the issuance of a new Drivers license by the concerned government agency who issued the same.

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IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of December, 2008, at Baguio City, Philippines.

LALA KARLA NAWALA Affiant

SUBSCRIBED AND SWORN to before me this 15th day of December, 2008, at Baguio City by the affiant personally known to me and to me known to be.the same person who personally appeared and signed before me the foregoing affidavit and acknowledged that she executed the same.