Republic of the Philippines)

City of Bacolod ……………..)S.S

X----------------------------------x

AFFIDAVIT OF LOSS

I, RUPERT JOY N. SENADRE, of legal age, Filipino, single, and a

resident of Phase VI-B, Block 41, Lot 15, Brgy. Handumanan, Bacolod City,
Philippines, after having been sworn to in accordance with law, hereby
depose and say that:

1. I am the holder of a certification (Certification No. KLMA-G-02A-

12717) issued by “K” Line Maritime Academy on April 21, 2015
pertinent to the completion of training on SHIP SECURITY
AWARENESS TRAINING AND SEAFARERS WITH DESIGNATED
SECURITY DUTIES.

2. On or about July 2019, while I am in transit on a bus from my dormitory, I

inadvertently left my belongings in the bus and said certification was
included therein.

3. Despite diligent search and efforts to locate the said certification, I could no
longer find it and I believe that the same was lost beyond recovery;

4. I am executing this affidavit to attest to the truthfulness of the foregoing.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

_________________________ at Bacolod City, Philippines.

RUPERT JOY N. SENADRE

Affiant

SUBSCRIBED AND SWORN TO before me this ____________. Affiant

exhibited to me his TIN with no. 468442-512-000 as competent proof of his
identity.

Doc. No. ______;

Page No. ______;
Book No.______;
Series of 2019.
REPUBLIC OF THE PHILIPPINES)
CITY OF BACOLOD ……………..)S.S.
X-------------------------------------------X

AFFIDAVIT OF LOSS

I, JOEL H. MOSQUERA, Jr., Filipino, and a resident of B28 L4 Phase I,

Grandville Subd., Brgy. Mansilingan, Bacolod City, Philippines, after
having been sworn in accordance with law, hereby deposes and states the
following:

5. That I am a registered holder of Student Driver’s Permit;

6. That my father, JOEL P. MOSQUERA, used to place the said Student

Driver’s Permit in his wallet however, sometime in December 20, 2018, he
discovered that the said permit was no longer in his wallet;

7. That despite diligent search and efforts to locate the said Student Driver’s
Permit I could no longer find it and I believe the same was lost beyond
recovery;

8. That I am executing this affidavit for purposes of my application for the

replacement of my lost Student Driver’s Permit;

9. I attest to the truthfulness of the foregoing.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

______ day of December 2018 at Bacolod City, Philippines.

JOEL H. MOSQUERA, Jr.

Affiant

SUBSCRIBED AND SWORN TO before me this ____________. Affiant

exhibited to me his _______________ with no. _______________________ as
competent proof of his identity.

Doc. No. ______;

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

REPUBLIC OF THE PHILIPPINES)

CITY OF BACOLOD ……………..)S.S.
X-------------------------------------------X

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, JOEL P. MOSQUERA of legal age, Filipino, and a resident of B28 L4

Phase I, Grandville Subd., Brgy. Mansilingan, Bacolod City, Philippines,
after having been sworn in accordance with law, hereby deposes and
states the following:

1. That I am a registered holder of a Non-Professional Driver’s License;

2. That I used to place the said Driver’s License together with my son’s
Student Driver’s Permit, in my wallet however, sometime in December 20,
2018, I discovered that the said Driver’s License and Student Driver’s
Permit was no longer in my wallet;

3. That despite of diligent search and efforts to locate the said Driver’s
License I could no longer find it and I believe the same was lost beyond
recovery;

4. That I am executing this affidavit for purposes of my application for the

replacement of my lost Driver’s License;

5. I attest to the truthfulness of the foregoing.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

______ day of December 2018 at Bacolod City, Philippines.

JOEL P. MOSQUERA
Affiant

SUBSCRIBED AND SWORN TO before me this ____________. Affiant

exhibited to me his _______________ with no. _______________________ as
competent proof of his identity.

Doc. No. ______;

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