REPUBLIC OF THE PHILIPPINES)

Province of Zamboanga del Sur ) S.S.

City of Pagadian )
x--------------------- x

AFFIDAVIT OF LOSS

I, MC RONN S. EDAÑO, Filipino, of legal age, single, and a resident of

Pagadian City, Philippines, after being duly sworn to in accordance with law, do
hereby depose and state:

1 That I secured a Student Permit (SP) issued by the LTO Office,

Pagadian City branch;
2 That the SP while in my possession was misplaced and could no longer
be located despite diligent search and effort;
3 That I could not find them such that I now believe that they are now
lost beyond recovery;
4 That my SP 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
SP Card in lieu of the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 18 July 2018

at Pagadian City, Philippines.

MC RONN S. EDAÑO

SUBSCRIBED AND SWORN to before me, this 18 July 2018, by the Affiant
who is personally known to me and who exhibited his Government Issued ID No.
___________.

Doc. No. ______;

Page No. ______;
Book No.______;
Series of 20____.