REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CEBU ) S.S.

MUNICIPALITY OF MINGLANILLA )

AFFIDAVIT OF LOSS

I, JAYMAR D. DEJAMO , Filipino, of legal age, single, and a resident of Lipata,

Minglanilla, Cebu, after being duly sworn to in accordance with law, hereby depose and
say:

That I am a holder of a Professional Driver’s License, issued by the LTO at Cebu

City;

That on May 11, 2007, while at the vicinity of Banilad, Cebu City, my bag
containing the said Professional Driver’s License, was lost;

That said Professional Driver’s License was not confiscated by any authorities;

That said Professional Driver’s License could not anymore be found

notwithstanding my diligent efforts to locate the same, hence considered as lost for all
legal intents and purposes;

That this affidavit is executed to be able to transact business with LTO, Cebu City
for the purpose of securing another Professional Driver’s License, in lieu of the lost one,
and for whatever legal purpose it may serve;

That the contents of this Affidavit are true and correct according to my best
knowledge and belief and that the same is executed without any fraudulent intention
against any person natural or juridical;

IN WITNESS WHEREOF , I have hereunto set my hand this 16 t h day of May 2007,
in the Municipality of Minglanilla, Province of Cebu, Philippines.

JAYMAR D. DEJAMO
Affiant
CTC No. 24952708
Issued on 05-16-07
At Minglanilla, Cebu

SUBSCRIBED AND SWORN TO BEFORE ME , in the Municipality of

Minglanilla, Province of Cebu, this 16 t h day of May 2007. Affiant showing his CTC
number, date and place of issue as indicated above below hiS name and signature.

Doc No.___________; SAMUEL S. ADLAWAN

Page No.__________; Notary Public
Book No.__________; UNTIL DEC. 31,2007
Series of 2007 NOT. COM. NO. 0304
PTR NO. 8496958-1-02-06
IBP NO. 632349-11-16-05
CEBU PROVINCE
ROLL NO. 38124