Republic of the Philippines) of

Batangas )s.s.
X X

AFFIDAVIT OF LOSS

I REMEGIO R. GARCIA, JR, of legal age, Filipino citizen, and resident of Barangay Luta Sur
Malvar , Batangas Philippines, after being duly sworn by law, hereby depose and state under
oath:

1. I am a duly licensed driver in accordance with pertinent Land Transportation laws, rules, and
regulations, and was issued a corresponding Professional Driver's License, I don’t remember the
driver’s License;

2. Sometime in January 2007, in the vicinity of Malvar said the driver's license was misplaced
and got lost;

3. Efforts were exerted to locate said driver's license, but despite diligent search, it could not be
found and the same is now beyond recovery;

4. Said Driver's License has not been confiscated by the LTO, Police, or other Traffic Enforcers
for any traffic violation;

5. 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 Professional Driver's License, in lieu of the one
that was lost;

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day of June 2024 in Malvar,
Batangas, Philippines.

REMEGIO R. GARCIA, JR
Affiant
Identification Card: National ID
No. 3769-5720-6741-0291

SUBSCRIBED AND SWORN to before me on this 20th day of June 2024, in Malvar, Batangas
Philippines.

Doc. No._________;
Page No._________;
Book No._________;
Series of 2024.