REPUBLIC OF THE PHILIPPINES )

QUEZON CITY ) S.S.

AFFIDAVIT OF LOSS

I, JEREMY YNNOS L. ABENOJA, of legal age, Filipino citizen, with

residence address at Laguna Bel-Air 2, Sta Rosa City, after having been duly
sworn to in accordance with law, hereby depose and state;

1. That I am the holder /owner of Driver’s License issued by Land

Transportation Office (LTO);

2. Said JEREMY YNNOS L. ABENOJA were usually kept in my wallet

for safe keeping;

3. However, due to inadvertence and/or oversight, I discovered that the

above-mentioned Driver’s License were missing and its whereabouts
are unknown;

4. That I exerted diligent efforts to locate and look for the above-
mentioned Driver’s License in other places, but the same proved futile
and to no avail;

5. For all intents and purposes, I am now declaring the above-mentioned

Driver’s License lost and beyond recovery;

6. I execute this Affidavit to attest to the truth of the foregoing facts

based on my personal knowledge and for whatever legal purpose it
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 7th day of December
2020 at Quezon City, Philippines.

JEREMY YNNOS L. ABENOJA

Affiant

SUBSCRIBED AND SWORN to before me this 7th day of December 2020 at

Quezon City, Philippines. Affiant exhibited to me her CTC/ID No.
_______________issued on ____________________ at ________________________.

Doc. No.: _____________ NOTARY PUBLIC

Page No.: _____________
Book No.: _____________
Series of 2020