Republic of the Philippines)

Province of __________ ) S.S

City of ________ )
x-----------------------------------x

AFFIDAVIT
I, _________________________, of legal age, Filipino, married and a
resident of ________________ under oath, state:
1. That I am a bonafide licensed driver having been issued by the Land
Transportation Office (LTO) a Non-Professional Driver’s License No.
__________________ with indicated Restrictions: 1,2;
2. That, however, I have only the ability, skills and capacity to drive any
vehicle up to 4500 KGS G V W as described under the Restriction
No. 2 in my said license;
3. That I previously drove motorcycles/motorized tricycles as described
under the Restriction No. 1 in my said license, but I lost balance one
time while I was driving, hence, it resulted to my trauma and fear for
driving motorcycles again;
4. That so as not to avoid any fraud whatsoever, it is only proper that
the Restriction No. 1 indicated in my said license BE DROPPED
accordingly and that a new driver’s license be issued anew with
indicated restriction under number 2 only;

5. That I attest to truth of the foregoing facts, for all legal intents and
purposes.
IN WITNESS WHEREOF, I hereunto affixed my signature this day of
___________ at ________________.

________________________________
Affiant
NPDL ID No: ____________

SUBSCRIBED AND SWORN to before me this day of ______________

at _____________________ by affiant who is personally known to me and
further exhibited to me her competent identification as shown above.