REPUBLIC OF THE PHILIPPINES )

MUNICIPALITY OF SAN JUAN ) S.S.

PROVINCE OF LA UNION )

AFFIDAVIT OF LOSS

I, RUFINA N. PINZON, of legal age, married, Filipino and a resident of

Napaset, Luna, La Union, after being sworn in accordance with law, hereby
depose and state that:

1) I am the buyer/vendee of that parcel of land located at Paringao, Bauang,

La Union containing an area of SIX HUNDRED TWELVE (612) SQUARE
METERS covered by Transfer Certificate of Title No. T-26403 of the Registry
of Deeds of La Union as evidenced by the Deed of Absolute Sale of a
Registered Land which was executed in my favor by VERONICA NAVERA
and thereupon acknowledged before Notary Public, Donato B. Caloza and
docketed in his Notarial Registry as “Doc. No. 84; Page No. 17; Book No. CII;
and Series of 2018.” A copy of the said Deed of Absolute Sale of a Registered
land is hereto attached and made an integral part hereof as ANNEX “A”;

2) Immediately after the Deed of Absolute Sale of a Registered Land was

executed, the original owner’s duplicate copy of Transfer Certificate of Title
No. T-26403 was turned-over to me by Veronica Navera. She likewise
delivered to me possession of the subject parcel of land and since then I have
openly exercised and maintained all rights of ownership thereon. A photocopy
of the duplicate owner’s copy of the said Transfer Certificate of Title
(microfilm copy) is hereto attached and made an integral part hereof as
ANNEX “B”;

3) I was not able to immediately transfer the title in my name because I

was then preoccupied with our family business;

4) Sometime in November, 2018, I decided to process the transfer of title

in my name, because I finally had the time and opportunity to do so through my
Affidavit of Loss; re: owner’s duplicate copy of TCT No. T-26403 Page 1 of 3

(RUFINA N. PINZON)
Attorney-in-Fact, Remedios del Mundo Tagarro to whom I entrusted the safe
keeping of the subject document since it was my intention to retain her in
facilitating the process of transferring in my name the parcel of land subject of
this Affidavit;

5) It was then that I advised her to go on with the process of transferring in

my name the said parcel of land using the owner’s duplicate copy of Transfer
Certificate of Title No. T-26403 and to prepare all other requirements necessary
in the process;

6) After conferring with my Attorney-in-Fact sometime in January 2019, I

was told by her that she inadvertently misplaced the subject document and
despite extensive effort on her part to find the same, she could no longer find it
and therefore considered lost forever;

7) My Attorney-in-Fact, Remedios del Mundo Tagarro executed an

affidavit confirming the loss of the subject owner’s duplicate copy of
Transfer Certificate of Title No. T-26403 I entrusted to her and the
circumstances surrounding such loss. Copy of the Affidavit of Confirmation of
Loss anent the subject owner’s duplicate of title is hereto attached and made an
integral part hereof as “ANNEX “C”;

8) I certify and confirm that the parcel of land covered by Transfer

Certificate of Title No. T-26403 of the Registry of Deeds of La Union was
never mortgaged, sold, conveyed, disposed of, or encumbered to any other
person or entity. Moreover, I certify and confirm further that the said document
was neither confiscated, nor relinquished in favor of any government entity,
agency or authority; and

9) I attest to the truth of the foregoing statements to the best of my own

personal knowledge and based on authentic documents or 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-26403, as well as for all
lawful intents and purposes it may serve.

IN WITNESS WHEREOF, I set my hand this ____ day of

___________________, 2019 at _____________________, La Union.

Affidavit of Loss; re: owner’s duplicate copy of TCT No. T-26403 Page 2 of 3

(RUFINA N. PINZON)
 RUFINA N. PINZON
Affiant
ID No. ___________________

SUBSCRIBED AND SWORN to before me this ___ day of

___________________, 2019 at _____________________, La Union.

__________________________
Notary Public

Affidavit of Loss; re: owner’s duplicate copy of TCT No. T-26403 Page 3 of 3

(RUFINA N. PINZON)