Republic of the Philippines)

Malolos City, Bulacan ) S.S

AFFIDAVIT OF LOSS
I, REYNANTE E. VESITO, of legal age, single, Filipino, and a
resident of Santos Compound, Malinta Bukid, Malinta, Valenzuela City,
after having been duly sworn to in accordance with law do hereby depose
and state, that:

1. I am a holder of a Driver’s License duly issued to me by the Land

Transportation Office (LTO Valenzuela City);

2. On October 13, 2019, while I was riding a tricycle going to

Maburipa, Lincon Pasolo, I noticed that my wallet was missing;

3. The said wallet containing some cash, receipts, included the

subject LTO Driver’s License was unnoticeably dropped
somewhere in Maburipa, Lincon Pasolo;

4. I have exerted diligent efforts to locate the same but all our efforts
proved to be all in vain; and

5. I am executing this affidavit to attest to the truth of the foregoing

statements and for all legal intent and purposes it may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 15 th

day of October 2019 at Malolos City, Philippines.

REYNANTE E. VESITO
Affiant

SUBSCRIBED AND SWORN to before me this 15th day of October

2019. Affiant exhibited to me his ____________________.

Doc. No. 436;

Page No. 89;
Book No. XIII;
Series of 2019.