Affidavit of Loss: Republic of The Philippines) Province of Bulacan) S.S. City of Malolos)

Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 1

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF BULACAN ) S.S.


CITY OF MALOLOS )

AFFIDAVIT OF LOSS

I, LEO ANTHONY FELICIANO RABULAN, of legal age, Filipino


citizen, and with residence address No. 463 M. Billien Upper, Mapakla,
Jala-Jala, Rizal, after having been sworn to in accordance with law, do
hereby depose and say, that:
1. I am the holder of a Professional Driver’s License issued by
Land Transportation Office.
2. As I usually do, I keep all my identification cards inside my
wallet including the said Professional Driver’s License despite the fact that
I moved abroad to work. Secured that the Professional Driver’s License
will not be lost, I have not bothered to check on it. And upon my return
this April 2018 to the Philippines with the hopes of renewing my
Professional Driver’s License, I looked for it inside my wallet but it was no
longer there.
3. I exerted all efforts to locate my Professional Driver’s License
but to no avail;
4. I am executing this affidavit to attest to the truth of all the
foregoing facts, and to secure a replacement for my Professional Driver’s
License and for all legal intents and purposes that this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


16th day of May 2018, here at City of Malolos, Bulacan.

LEO ANTHONY FELICIANO RABULAN


Affiant

SUBSCRIBED AND SWORN to before me this 16th day of May


2018.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2018.

You might also like