Republic of the Philippines }

CITY OF KIDAPAWAN } ss.

x- - - - - - - - - - - - - - - - - - x

AFFIDAVIT OF LOSS

I, JOHN ABRUZZI, of legal age, Filipino, single and a resident of

Mundog Subdivision, Poblacion, Kidapawan City, North Cotabato,
after having been sworn to in accordance with law, do hereby 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 Professionals Driver License with number
D16-05-301715 which is valid until March 2019;

2. Sometime in April 2017, said Drivers License was misplaced

and 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 Drivers License, in lieu of the one that was
lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 16th

day of June 2017 in Kidapawan City, Philippines.

JOHN ABRUZZI
Affiant
Voters ID VIN: 2319-0492A-C0390ASL20000
 SUBSCRIBED AND SWORN to before me this this 16th day of
June 2017 in Kidapawan City, Philippines, Affiant exhibiting to me His
valid identification document indicated below his name.

Notary Public

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2017.