Scribd
Upload
97 views1 page

Affidavit of Loss: Republic of The Philippines) City of Manila S.S.

1) Carlo Marco Y. Pelagio filed an affidavit of loss stating that he is the holder of a driver's license with number N0412003962. 2) He discovered that his driver's license was irretrievably lost on February 14, 2020 despite diligent efforts to locate it. 3) He executed the affidavit to attest to the truth of the information provided regarding the loss of his driver's license.

Uploaded by

Ayesha Cyril OigaLep
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
97 views1 page

Affidavit of Loss: Republic of The Philippines) City of Manila S.S.

1) Carlo Marco Y. Pelagio filed an affidavit of loss stating that he is the holder of a driver's license with number N0412003962. 2) He discovered that his driver's license was irretrievably lost on February 14, 2020 despite diligent efforts to locate it. 3) He executed the affidavit to attest to the truth of the information provided regarding the loss of his driver's license.

Uploaded by

Ayesha Cyril OigaLep
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

Republic of the Philippines )

City of Manila
S.S.____________,_____________

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, CARLO MARCO Y.PELAGIO of legal age, Filipino, single/married, and a resident of


1432-A. Franco Street Tondo Manila ,after having been sworn in accordance with law,
hereby deposes and states the following:
1. I am holder/owner/ or possessor of the following identification card / document:
2. DRIVERS LICENSE with Lic. # N0412003962
3. I have recently discovered the said item/s is/are irretrievably lost last February
14,2020 and can no longer be found despite diligent efforts to locate the same;
4. I execute this affidavit to attest to the truth of the foregoing.

CARLO MARCO Y. PELAGIO


(Signature over Printed Name)
Affiant

SUBSCRIBED and SWORN TO before me on the date and at the place indicated below. The affiant
exhibited to me his competent evidence of identity as indicated above. Signed this ______________at
________________, ______________________, Philippines.
WITNESS MY HAND AND SEAL.
Notary Public
Doc. No.
Page No.
Book No. I
Series of

You might also like