REPUBLIC OF THE PHILIPPINES)

CITY OF QUEZON ) S.S.

AFFIDAVIT OF LOSS

I, ERVIN MARK C. ROTO, Filipino, of legal age, single, with residence at No. 4845
NPC Sukaban, Bagbaguin, Caloocan City, after having been sworn in accordance
with law, hereby depose and state that:
 

1. I am a Driver’s License holder with the Land Transportation Office (LTO);

2. I accidentally misplaced my wallet including my Driver’s License;

3. I exerted effort to locate the said Driver’s License but could no longer be found
and should now be considered lost and beyond recovery for all intents and
purposes;

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

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of February,
2021 at Quezon City.
                  

______________________
ERVIN MARK C. ROTO
Affiant

 
          SUBSCRIBED AND SWORN to before me, this _____ day of February, 2021 in Quezon
City, Philippines with affiant exhibiting his ___________________ issued on ________ at
Quezon City, Metro Manila Philippines.
 
 
NOTARY PUBLIC

Doc.  No. :  ________;

Page  No. :  ________;
Book No. :  ________;
Series of 2021.
REPUBLIC OF THE PHILIPPINES)
CITY OF QUEZON ) S.S.

AFFIDAVIT OF LOSS

I, ELSA M. CAÑETE, Filipino, of legal age, with residence at No. 436 Tabigo St.,
Commonwealth, Quezon City, after having been sworn in accordance with law, hereby depose
and state:
 
1. That I have a Savings Account with BDO Timog branch with Account No.
002560120247;

2. That I misplaced my BDO Passbook Savings Account;

3. That I exerted effort to locate the said Passbook but could no longer be found and
should now be considered lost and beyond recovery for all intents and purposes;

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

 
IN WITNESS WHEREOF, I have hereunto set my hand this 18th day of February, 2021,
at Quezon City.
                  

__________________
ELSA M. CAÑETE
Affiant

 
          SUBSCRIBED AND SWORN to before me, this ____ day of February, 2021 in Quezon
City, Philippines with affiant exhibiting her Professional Identification No. 0071436 valid until
November 5, 2023 issued at Pasay City, Metro Manila Philippines.
 
 
NOTARY PUBLIC

Doc.  No. :  ________;

Page  No. :  ________;
Book No. :  ________;
Series of 20 _______.