Documente Academic
Documente Profesional
Documente Cultură
______________________________) S.S.
AFFIDAVIT OF LOSS
I, MARIA LUISA SUYO GALANG of legal age, Filipino, single, and a resident of #4
Mercury St. Pacita 2 San Pedro, Laguna , after having been sworn in accordance with law,
hereby depose and state the following:
3. That on 21 January 2018, while my family and I were attending mass, the window
of my car was smashed and destroyed by an unknown thief and stole items
therein;
4. That said thief took with him, among others, my wallet which contains my
Driver’s License;
5. That due to the incident, my Driver’s License is now believed to be lost beyond
recovery;
6. That my Driver's License has not been confiscated by the LTO, Police or other
Traffic Enforcers for any traffic violation;
NOTARY PUBLIC
Doc. No. _______;
Page No. _______;
Book. No. _______;
Series of 2018.