REPUBLIC OF THE PHILIPPINES)

Cebu City ) SS.

AFFIDAVIT OF LOSS

I, Edrian Ortega Cañete, single, of legal age and a resident of

M.L Quezon Street, Loran Road, Cabancalan, Mandaue City, Cebu
Region 7 (Central Visayas) 6045 under oath, state:

1. THAT on the 23rd of August 2023, I went to the birthday party

of my friend in San Isidro, Talisay City, Cebu. While disembarking
from the vehicle that I was driving, I noticed that my wallet was no
longer in my pocket;

2. THAT my wallet contained my Driver’s License.

3. THAT I exerted diligent efforts to locate my wallet but to no

avail and I therefore considered the same as lost and can no longer
be found;

4. THAT I am executing this Affidavit to attest to the truth of the

foregoing facts and to use the same for whatever legal purpose it
may serve.

IN WITNESS WHEREOF, I hereunto affix my signature this

January 13, 2020 at Cebu City.

EDRIAN ORTEGA CAÑETE

Affiant

SUBSCRIBED AND SWORN before me this 10th day of

November 2023, Cebu City Philippines.

Notary Public

Doc No. 16
Page No. 5
Book No. 1
Series of 2023