Republic of the Philippines)

Dumaguete City. ) S.S.

Affidavit of Loss

I, JANICE A. GAROL, of legal age, Filipino, single, a resident of No. 1, De Jesus

Compound, Manino Drive, Daro, Dumaguete City, after having been sworn to in
accordance with law, depose and state that:

1. I am the owner of a certain parcel of land, Lot No. 1698, situated in Tubod,
Bacong, Negros Oriental, covered under Original Certificate of Ttile No. 7071
(CLOA NO. 00112982), by virtue of a Declaration of Heirship, Extrajudicial
Settlement of Estate and Sale identified as Doc. No. 58; Page No. 13; Book No.
I, Series of 2016 in the notarial register of Atty. Ernesto G. Valencia;

2. Upon sale, I was given possession of the original Owner’s Duplicate Copy of the
said title where I placed it inside a folder together with other important
documents;

3. Last January 24, 2020 at around 9:50 o’clock in the morning, I brought with me
the folder containing the documents and the title and I placed it inside my car;

4. When I was on my way to fetch my children from school, I discovered that the
folder containing the documents and the title was no longer inside the car where I
last placed it;

5. Upon tracing back the places where I went to, I was unable to locate the folder
and was unable to recover the same;

6. I believe I must have dropped the folder or have left it somewhere where I can no
longer remember;

7. After exerting diligent efforts to find an locate the folder containing the title, the
documents as well as the original copy of the Owner’s Duplicate Copy of OCT
No. 7071 was never found and is now considered lost beyond recovery;

8. I am executing this affidavit to attest to the truthfulness and veracity of the

forgoing in support of the Petition for Issuance of New Owner’s Duplicate Copy of
Title for OCT No. 7071 in lieu of the lost one.

IN WITNESS WHEREOF, I hereunto affix my signature this

__________________ in Dumaguete City.

JANICE A. GAROL
Affiant

SUBSCRIBED AND SWORN to before me this ________________ by affiant

exhibiting to me her _____________________ as proof of identity. Known to me to be
the same person who executed the forgoing affidavit of loss and acknowledged to me
that the same is her free and voluntary act and deed.

Doc. No. _____;

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