Republic of the Philippines)

City/Municipality of Manila ) S.S.

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

AFFIDAVIT OF LOSS

I, JOJO REYES SALVADOR, of legal age, Filipino, and a residence of #35

Kabalitang Street Krus Na Ligas, Quezon City, after being duly sworn to in accordance
with law, hereby depose and state:

That I am the owner/holder of the DRIVERS LICENSE with NO. N0216522201

issued by Land Transportation Office;

That on October 6, 2017 the aforementioned Drivers License was accidentally

drop somewhere without my knowledge and awareness;

That I tried to recover the same but effort found futile;

That I am executing this Affidavit in order to attest to truth of the foregoing

and for whatever legal intents it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7 th of October 2017 at

Manila City, Philippines.

JOJO REYES
SALVADOR
Affiant

SUBSCRIBED AND SWORN to before me on this 7th of October 2017 at Manila

City, affiant exhibited to me his competent evidence of identity.

Doc. No.
Page No.
Book No.
Series of 2017