REPUBLIC OF THE PHILIPPINES)

TARLAC CITY )S.S.

AFFIDAVIT

I, CHRISTIAN B. GUIWA, of legal age, and a resident of San Agustin,

Concepcion, Tarlac, after having been duly sworn to in accordance with law, do
hereby depose and say, to wit:

1. That I am a holder of Driver’s License issued by Land Transportation

Office (LTO);

2. That sometime on August this year, while I am on my way to work

somewhere in Barangay San Jose, Concepcion, Tarlac, and upon
arrival thereat, I discovered that my wallet lost containing my Driver’s
License and other pertinent documents;

3. That recently, despite diligent efforts exerted to locate the same, it

could no longer be found and is now deemed lost and beyond
recovery;

4. That I am executing this affidavit to attest to the truth of the

foregoing statements and facts.

AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 28th day of

September 2018 at Tarlac City, Philippines.

CHRISTIAN B. GUIWA
Affiant

SUBSCRIBED AND SWORN to before me this 28th day of September 2018

at Tarlac City, Philippines.

Doc. No. _____;

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