REPUBLIC OF THE PHILIPPINES )

Legazpi City ) S.S.

AFFIDAVIT OF LOSS

I, CAIN N. ABEL, of legal age, Filipino Citizen and a resident of 123

Lapu-lapu Street, Legazpi City, under oath, hereby depose and state that:

1. I am a holder of LTO Driver’s License ID;

2. On April 12, 2021, I surrendered said driver’s license ID to the
guard on duty at the entrance of UST-Legazpi as to be able to enter
the school premises;
3. Upon retrieving the ID, the guard to whom I surrendered was not
around and decided to return the next day. However, when I
returned the next day, the guard misplaced the ID and could no
longer locate it;
4. Despite diligent efforts of searching to locate said driver’s license
ID, the same proved futile. I now consider it irretrievably lost;
5. I am executing this affidavit to attest to the truth of all the
foregoing and in order to support my application to replace the lost
driver’s license and credit card and for other legal purpose this may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 24th of

April 2021 in the City of Legazpi, Philippines.

CAIN N. ABEL
Affiant
Passport No. B0123456

SUBSCRIBED AND SWORN TO before me this 24TH of April 2021 at

Legazpi City. Affiant further exhibited to me his competent proof of identity
through the document written below his name, pursuant to Rule 2, Sec. 12
(a) of the 2004 Rules on Notarial Practice.