1.

That I am a duly-licensed driver in accordance with pertinent Land Transportation laws, rules
and regulations and was issued a corresponding Non- Professional Driver’s License with number
H12-34-567890 which is valid until June 2025.

2. That on March 1, 2021, while I was on my way to Arellano University School of Law to enroll,
the UV express I was riding got hold up;

3. That my wallet was taken by the robber and my Driver’s License was inside said wallet;

4. That I have not driven any motorized vehicle ever since my Driver’s License was lost;

5. Said Driver’s License has not been confiscated by the LTO, Police or other Traffic Enforcers for
any traffic violation;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and to
support my application for the issuance of a new Driver’s License, in lieu of the one that was
lost.