Affidavit of Loss: Eugene A. Tiña

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Republic of the Philippines)

City of Davao )S.S.


x------------------------------------x

AFFIDAVIT OF LOSS
I, EUGENE A. TIÑA, of legal age, Filipino, single, and a
resident of Dela Peña Village, Cabantian, Davao City, after having
been duly sworn in accordance with law, hereby depose and say
that:

1. I am the person whose personal circumstances are


described in this affidavit;

2. On 23 July 2020, my driver’s license identification card


with license no. L02-18-000291 issued by the Land
Transportation Office (LTO), Davao City branch Office was
unfortunately lost while I was roaming around Davao
City;

3. I exerted due diligence and persistent efforts in locating


said ATM but to no avail and I now consider the same as
irretrievably lost;

4. I am executing this Affidavit to attest to the truth and


veracity of all the foregoing and to use the same for
whatever legal purpose it may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my


signature this ______________at Davao City, Philippines.

EUGENE A. TIÑA
Affiant
Student I.D. No. 31465

SUBSCRIBED AND SWORN to before me this


_______________ at Davao City, Philippines. For purposes of
evidence of identity, affiant exhibited to me his identification
document as indicated above.

Doc No. ___;


Page No. ___;
Book No. ___;
Series of 2020.

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