Affidavit of Lost License-Soo

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Republic of the Philippines ) Province of Davao del Norte ) s.s.

City of Tagum ) x- - - - - - - - - - - - - - - - - -x AFFIDAVIT OF LOST LICENSE , GLEIZL JOY C. SOO! of legal age! "ilipino! married! and a resident of Tagum City! Davao del Norte! Philippines! after having duly s#orn to in accordance #ith la#! depose and say$ That am a holder of Professional Driver%s &icense '''''''''''''''''''''' issued by the &and Transportation (ffice) That the said license #as lost together #ith my #allet #here year ago) That serious efforts exerted to locate the same proved in vain) That have not been apprehended for violation of any traffic rules and regulations. That am executing this +ffidavit to attest to the truthfulness of the foregoing fact and in connection #ith the re,uirement of the &and Transportation for the issuance of a ne# license in lieu of the lost one. IN TRUTH HEREOF! Tagum City! Philippines. have hereunto set my hand this '''''''''' at No.

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GLEIZL JOY C. SOO +ffiant '''''''''''''''' SUBSCRIBED AND SWORN to before me this '''''''''''''''' at Tagum City! Philippines. Doc. No. ____; Page No. ____; Book No. ____; Series of 2013.

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