REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAMARINES NORTE ) SS.

MUNICIPALITY OF DAET )

AFFIDAVIT OF LOSS

I, ARCHIE V. GONZALES, of legal age, Filipino citizen, married, and

with residence and postal address at 118 Hernandez St., Tondo, Manila,
after having been duly sworn to in accordance with law, hereby depose
and say:

That I was the holder of Professional Drivers License issued by the

Land Transportation Office (LTO);

That I always brought said license with me as may be needed for

identification purposes in my business transactions and likewise as
required by law to be in possession whenever I was driving my motor
vehicle;

That however, sometime in October, 2016, upon arriving home in

Tondo, Manila coming from work, I discovered that my wallet containing
said license was missing from the back pocket of my pants;

That utmost efforts were exerted in trying to find and retrieve my

drivers license, but to no avail, and now the same is considered lost and
beyond recovery;

That said license was not confiscated by the PNP/LTO or any

deputized law enforcement personnel for any traffic/driving violation, but
the same in all likelihood was merely lost by accident while I was
travelling on my way home;

That I am executing this affidavit to attest to the loss of my

professional drivers license, to request the Land Transportation Office
(LTO) for the issuance of a new driver license in lieu of the one lost, and
for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day

of February, 2017, in Daet, Camarines Norte.

ARCHIE V. GONZALES
Affiant

SUBSCRIBED AND SWORN to before me this 20th day of February,

2017, in Daet, Camarines Norte, by the above-named affiant who
presented to me his UMID CRN-0111-0489902-2 as competent evidence
of his identity.

Doc. No. 236

Page No. 48
Book No. 2
Series of 2017.