REPUBLIC OF THE PHILIPPINES}

MUNICIPALITY OF PATEROS } S.S.

METRO MANILA }

AFFIDAVIT OF LOSS

I, NEIL R. ABRECEA, of legal age, Filipino and resident of 173 P.

Rosales Street, Pateros, Metro Manila, under oath depose and say that –

1. I am a holder of a Non-Professional Driver’s License issued by LTO.

2. That I am keeping my Driver’s License at my wallet.

3. That on the night of February 9, 2020, I lost my wallet containing

the aforesaid Non-Professional Driver’s License somewhere in
Pateros, Metro Manila, either it accidentally fell off from my pocket
or some unidentified perpetrator took it from my pocket.

4. I exerted diligent effort to locate my Driver’s License, but proved

futile, hence, I considered it already lost and beyond retrieve.

5. I hereby bind myself to surrender and inform the LTO in the event
that the said Driver’s License is found or located.

6. I am executing this Affidavit of Loss to attest the truth of the

foregoing and for whatever legal purposes this may serve.

IN WITNESS WHEREOF, I affixed my signature this February 10,

2020 at Pateros, Metro Manila.

NEIL R. ABRECEA
Affiant

SUBSCRIBED AND SWORN to before me this February 10, 2020

at Pateros, Metro Manila with Affiant affixing his signature in my
presence and within my notarial jurisdiction.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2020