REPUBLIC OF THE PHILIPPINES )

Province of Negros Oriental )

City of Dumaguete )S.S.
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AFFIDAVIT OF LOSS

I, MARIO RICHARD DANONG, of legal age, Filipino, married and a resident

of Bajumpandan, Dumaguete City, Negros Oriental, after having been sworn in
accordance with law, hereby deposes and states the following that:

1. That I am a duly-licensed driver in accordance with pertinent Land

Transportation laws, rules and regulations, and was issued a Driver's
License at LTO Dumaguete City sometime in September 2017;

2. That I have placed the said license at the back pocket of my pants while I
was driving a pedicab;

3. However, yesterday, July 16, 2018, when I reached home, I noticed that
said ID is no longer in my pocket;

4. That I tried to trace back my path, but to no avail, I couldn’t find the same.

5. That despite diligent search and efforts to locate my wallet with my ID, I
could not find the same such that I now believe that it is now lost beyond
recovery;

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

7. 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 Driver's
License and for whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 17th day of July
2018 at Dumaguete City, Philippines.

MARIO RICHARD DANONG

 Voter’s ID 4610-0091C-I1375MPD1000
Affiant

SUBCRIBED AND SWORN TO before me this 17th day of July 2018

in Dumaguete City, Philippines, affiant exhibiting to me his competent proof of
identification.

WITNESS MY HAND AND SEAL.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2018.