AFFIDAVIT OF LOSS - WALLET - Banjo Bambico

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Republic of the Philippines )

Province of La Union )S.S.


Municipality of Naguilian )
x----------------- --x

AFFIDAVIT OF LOSS
I, BANJO C. BAMBICO, Filipino, of legal age, married and a resident of
Nagsidorisan, Naguilian, La Union, Philippines, after being duly sworn to in
accordance with law, hereby depose and state:

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


Transportation laws, rules and regulations, and was issued a
corresponding Driver's License;

2. That on February 2, 2017 at around 10:30 am, while I was on board a


tricycle on my way to Guesset, Naguilian, La Union, I discovered that I
lost my wallet which I placed in the back pocket of my pants;

3. That inside said wallet are my driver’s license, Voter’s ID, municipal ID
(“Tattan Naguilian” ID) and other pertinent ID’s;

4. That despite diligent search and efforts to locate my wallet, ID’s and
driver’s license, I could not find them such that I now believe that they
are now lost beyond recovery;

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 my driver’s
license and ID’s in lieu of the ones that were lost and for all legal intents
and purposes that this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 2nd day of February 2017
at Naguilian, La Union, Philippines.

BANJO C. BAMBICO
Affiant

SUBSCRIBED AND SWORN to before me this 2nd day of February 2017 at Naguilian,
La Union, Philippines.

ATTY. LOVELLA MAY B. HULIGANGA


Notary Public until December 31, 2016
2nd floor, GACP Arcade Bldg., Ortiz,
Naguilian, La Union
Roll No. 62463; 04.29.13
IBP No. 1020116; 01.04.16
PTR No. 0671368; 01.04.16; La Union
MCLE Compliance No. V-0002517; 05.29.14
TIN No. 255-518-493

Doc. No. _______


Page No. _______
Book No. ______
Series of 2017

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