Republic of the Philippines

City of Zamboanga )s.s.

X------------------------------------X

AFFIDAVIT OF LOSS

I, ELIS MAGNO ESPERAT of legal age, single, Filipino citizen and a resident of
Uchida Drive, J. Johnston St., Baliwasan Tabuk, Zamboanga City, Philippines, after
having been duly sworn to in accordance with law, depose and say, that:

1. I am a holder of a Non-Professional Driver’s License duly issued by the Land

Transportation Office. Said Driver’s License was usually kept in my wallet;

2. Sometime last week, due to inadvertence, my wallet got lost together with the
said Driver’s License;

3. I exerted diligent efforts to locate and to look for the above-mentioned Driver’s
License in other places but the same proved futile;

4. For all intents and purposes, I am now declaring the above-mentioned Driver’s
License lost and beyond recovery;

5. I execute this Affidavit to attest to the truth of the foregoing facts based on my
personal knowledge and authentic records in compliance with the requirement of
the Land Transportation Office for the issuance of a new Driver’s License in lieu
of the lost one.

IN WITNESS WHEREOF, I have hereunto set my hand on this 16 th day of

December 2009 at Zamboanga City, Philippines.

ELIS MAGNO ESPERAT

Affiant

SUBSCRIBED AND SWORN to before me on this 16 th day of December 2009 at

Zamboanga City, Philippines.

GIAN PAOLO U. ENRIQUEZ

NOTARY PUBLIC
Zamboanga City
Until 31 December 2010
Notarial Commission No. 032-2009
Doc. No.____ Door 1, 2nd Floor, LDM Bldg.,Pilar St., Zamboanga City
Page No.____ PTR No. 0013439-01/07/09
Book No. XV IBP No. 727083-01/07/09
Series of 2009 At Zamboanga City
Roll No. 49871
MCLE Compliance No. II- 0012458-09/09/08