REPUBLIC OF THE PHILIPPINES)

City of Pagadian.) S.S.

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AFFIDAVIT OF LOSS
I, FLAVIO P. CARDERON, Jr., Filipino, of legal age, married
and with residence at Gate 5, Camp Abelon, Lumbia District, Pagadian
City after being duly sworn to in accordance with law, hereby depose
and state:
1. That I am a duly-licensed driver in accordance with pertinent
Land Transportation laws, rules and regulations;
2. That sometime in the year 2012, said Driver's License was
misplaced and got lost;
3. That despite diligent search and efforts to locate my Driver's
License, I could not find the same such that I now believe
that it is now lost beyond recovery;
4. That said Driver's License has not been confiscated by the
LTO, Police or other Traffic Enforcers for any traffic violation;
5. That I have not driven any motorized vehicle ever since my
Drivers License was lost;
6. 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 Driver's License, in lieu of the one that was
lost.
IN WITNESS WHEREOF, I have hereunto set my hand this
_____ day of April 2015 at Pagadian City, Philippines.

FLAVIO P. CARDERON, JR.

Affiant

SUBSCRIBED AND SWORN to before me this _____ day of

April 2015 at Pagadian City, Philippines.