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    Affidavit of Loss Drivers License

    Uploaded by

    Awi Tiosen
    This document is an affidavit of loss for a driver's license. It states that the affiant had a valid driver's license that was misplaced and lost after diligent search efforts. It further attests that the license has not been confiscated and this affidavit is being filed to support an application for a new license. The affiant signed and swore to the truth of the statements before a notary public.

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    © All Rights Reserved
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    Affidavit of Loss Drivers License

    Uploaded by

    Awi Tiosen
    140 views2 pages
    This document is an affidavit of loss for a driver's license. It states that the affiant had a valid driver's license that was misplaced and lost after diligent search efforts. It further attests that the license has not been confiscated and this affidavit is being filed to support an application for a new license. The affiant signed and swore to the truth of the statements before a notary public.

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    affidavit of loss form

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    This document is an affidavit of loss for a driver's license. It states that the affiant had a valid driver's license that was misplaced and lost after diligent search efforts. It further attests that the license has not been confiscated and this affidavit is being filed to support an application for a new license. The affiant signed and swore to the truth of the statements before a notary public.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    140 views2 pages

    Affidavit of Loss Drivers License

    Uploaded by

    Awi Tiosen
    This document is an affidavit of loss for a driver's license. It states that the affiant had a valid driver's license that was misplaced and lost after diligent search efforts. It further attests that the license has not been confiscated and this affidavit is being filed to support an application for a new license. The affiant signed and swore to the truth of the statements before a notary public.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    of 2

    Republic of the Philippines)

    Province of _______________) S.S.


    x-----------------------x
    Affidavit of Loss Drivers License
    I, ___________________, Filipino, of legal age, (single/married/widow/widower),
    and with residence at ____________________________, Philippines, after being
    duly sworn to in accordance with law, hereby depose and state:
    1. That I am a duly-licensed non-professional driver in accordance with
    pertinent
    LAND
    TRANSPORTATION
    LAWS,
    RULES
    AND
    REGULATIONS, and was issued a corresponding Driver's License with
    number _____________ which is valid until _____________;
    2. That three(3) days ago, said Driver's License was misplaced and got
    lost;
    3. That despite diligent search and efforts to locate my Driver's License, I
    could not find the same such that I now have reasons to believe that it is
    now lost and cant be recover;
    4. That 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 Driver's
    License, in lieu of the one that was lost.
    IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at
    _____________, Philippines.
    ___________(signature)___________
    AFFIANT
    SUBSCRIBED AND SWORN TO BEFORE ME, a notary public in and for
    _________(City/Province)____________ this ____th day of ____________ 20___.
    Affiant personally came and appeared with _____________(Competent Evidence of
    Identity)______ issued by the _________(Government Agency)______ on ___(date)__
    at ________(place)_________, bearing his photograph and signature, known to me as the
    same person who personally signed the foregoing instrument before me and avowed
    under penalty of law to the whole truth of the contents of said instrument.

    Doc. No. ____


    Page No. ____
    Book No. ____
    Series of 20__

    Atty ___________________________________________
    Notary Public
    Commission Serial No. ____________________________
    Notary Public for _______(Province/City)______________
    Until December 31, 20__
    Office: ______________(address)____________________
    Roll No. __________
    IBP Lifetime Roll No. _________; __/__/__ ; _(Province)_
    PTR No. _________ ; __/__/__ ; _(Province)_
    MCLE Compliance Cert. No. __________; __/__/__

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