REPUBLIC OF THE PHILIPPINES )

MEYCAUAYAN CITY BULACAN ) S.S.

AFFIDAVIT OF LOSS

I, DARLY A. BABAS, Filipino, of legal age, and a resident of Hulo St.,

Bagbagin, Meycauayan City, Bulacan, after being duly sworn to in accordance with
law, hereby depose and state that:

1. I am a holder of Driver’s License issued by the Philippine Land

Transportation Office (LTO);

2. Sometime in July 2017, I lost/ misplaced the said Driver’s License

somewhere in Hulo High-way, Karuhatan, Valenzuela;

3. Despite diligent efforts exerted to recover the same, the said driver’s
license can no longer be found and thus, considered lost for all legal purposes;

4. The said Driver’s License is not confiscated by any person in authority;

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 replacement and/or
renewal of the said driver’s license.

IN WITNESS WHEREOF, I have hereunto set my hand this 22nd day of August,
2018 at Meycauayan City, Bulacan, Philippines.

DARLY A. BABAS
Affiant

SUBSCRIBED AND SWORN to before me this 22nd day of August 2018, affiant
satisfactorily proven to me his identity through his SSS ID No. 33-7398019-7, and
that he is the same person who personally signed before me the foregoing affidavit and
acknowledged that he executed the same.

Doc No. 448;

Page No. 91;
Book No. II;
Series of 2018.