AFFIDAVIT OF LOSS

I, ANA THERESA D. OLAT, Filipino, of legal age, Single, and with residence at 393

Taganahan St., Bagumbayan South Navotas City, Philippines, after being duly sworn to in

accordance with law, hereby depose and state:

That I am a duly-licensed driver in accordance with pertinent Land Transportation laws, rules

and regulations, and was issued a corresponding Driver's License with number F0106008620

which is valid until October 28, 2022;

That sometime last week, said Driver's License was misplaced and got lost.

That despite diligent search and efforts to locate my Driver's License, I could not find the same

such that I now believe that it is now lost beyond recovery;

That said Driver's License has not been confiscated by the LTO, Police or other Traffic Enforcers

for any traffic violation.

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.

IN WITNESS WHEREOF, I have hereunto set my hand this __________________ at

____________________, Philippines.

ANA THERESA D. OLAT

AFFIANT