Republic of the Philippines ) S.S.

City of Butuan )
x--------------------------------------x

AFFIDAVIT OF LOSS

I, KING DARYL M. PELISCO, of legal age, Filipino, single, and a

resident of Village 2, Barangay Libertad, Butuan City, after being duly
sworn to in accordance with law, hereby depose and state that:

1. I am purchaser/vendee of that parcel of land located at Brgy

Bobon, Butuan City, with an area of FORTY THREE THOUSAND and
NINETY NINE (43,099) sq.m. covered by Transfer Certificate of Title
No. T-395 of the Registry of Deeds of Butuan City, as evidenced by the
Deed of Sale of a Registered Land which was executed in my favor by
LUZ TORRALBA-MATIAS, EDUARDO C. TORRALBA, SALVADOR M.
TORRALBA, JR., CORAZON TORRALBA-CAHOY, VIRGILIO C.
TORRALBA, MARIETTA N. TORRALBA, and ALBERTO T. ROSALES
and thereupon acknowledged before Notary Public ATTY CLINT T.
DABALOS and docketed in his Notarial Registry as “Doc. No. 259; Page
No. 52; Book No. LV; Series of 2016.” A copy of the said Deed of Sale
of a Registered Land is hereto attached and made an integral part hereof
as Annex A;

2. Immediately after the Deed of Sale of A Registered Land

was executed, the original duplicate owner’s copy of the Transfer
Certificate of Title No T-395 was turned over to me by the vendors;

3. I was not able to immediately effect the transfer of the

certificate of title in my name because I was then preoccupied with my
business in _____. Sometime in ________, when I decided to process
the transfer of the title in my name, having the time and opportunity to
do so, I discovered that the original duplicate owner’s copy of the
Transfer Certificate of Title was missing. I could no longer find it in my
files. Despite diligent efforts to locate and retrieve said certificate if title,
it was to no avail. Hence, for all legal intents and purposes, it is now
deemed lost and beyond recovery;
 4. I certify and confirm that the parcel of land covered by
Transfer Certificate of Title No. T-395 of the Registry of Deeds of Butuan
City was never mortgaged, sold, conveyed, disposed of, or encumbered,
to any other person or entity. I further certify and confirm that said
document was never confiscated nor relinquished in favor of any
government entity, agency, or authority;

5. I attest to the truth of the foregoing statements to the best

of my own personal knowledge and based on authentic records. I am
executing this Affidavit of Loss to support my application for a new
owner’s duplicate copy of Transfer Certificate of Title No. T-395 as well
as for lawful intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 18th

day of July 2019 at the City of Butuan, Philippines.

KING DARYL M. PELISCO

Affiant

SUBSCRIBED AND SWORN to before me this 18th day of July 2019, at

Butuan City, Philippines, affiant exhibiting his ___________________
as proof of his identity.

Doc. No. ______________;

Page No. _____________;
Book No. _____________;
Series of 2019