REPUBLIC OF THE PHILIPPINES)

Province of Isabela )
City of Ilagan ) S.S.

AFFIDAVIT OF LOSS

I, BRAULIO M. RUBIO, Filipino, of legal age, and a resident Brgy. Dummun

Gattran Cagayan, subscribing under oath, hereby depose and state:

1. That I am a the lone survivor of the late Mr. Cirilo Rubio married to Eulogia
Rubio and a holder of Transfer Certificate of Title No. T-18891 and a Certified
Technical Description of Lot described below:

Lot 1149-C, 1149-I and 1149-J of the subdivision plan PSD 69479 with an
area of 42,302 under TCT No. 18891 issued by the Register of Deeds.

2. That said Certified Technical Description and other documents issued by the
Register of Deeds;

3. That I usually store & keep the aforesaid documents on an envelop which I
usually bring with me when I intend to transfer of the said lot in my name.

4. That last 1998, when I looked for the said Technical Description in my envelop, I
could no longer locate it;

5. That said document could not be found notwithstanding diligent efforts to

locate the same and is now considered lost for all legal intents and purposes;

6. That I certify this oath to report to the Register of Deeds the loss of the Technical
Description issued by the Register of Deeds for purposes of re-issuing of said
document;

7. That I execute this affidavit to attest to the truth of all the foregoing facts and for
securing a Certified Technical Description.

IN WITNESS WHEREOF, I have hereunto affix my signature this 8th day of

October, 2019, at Tuguegarao, Cagayan.

BRAULIO RUBIO
Affiant

BEFORE ME, appears the person of BRAULIO RUBIO presenting the above Affidavit,
who is personally known to me who signs the document and in my presence taken an
oath or affirmation before me as to such document.

WITNESS MY HAND AND SEAL this 8th day of October 2019, at Tuguegarao,
Cagayan.
DOC. NO. ____;
PAGE NO. ____;
BOOK NO. ____;
SERIES OF 2019.