Republic of the Philippines)

La Trinidad, Benguet) s.s

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AFFIDAVIT OF LOSS

I, Romeo M. Guinaran, of legal age, married, Filipino citizen and a resident of FD 227,
Pines Park, La Trinidad, and Adaoay, Kabayan, Benguet Province, Philippines, after having duly
sworn to in accordance with law, do hereby and depose and state THAT:

1. I am the lawful and declared owner and possessor of a certain parcel of land located
at Bashoy, Kabayan, Benguet with an area of Four Thousand (4, 000) Square meters
covered by Tax Declaration of Real Property (TDRP) No. 2010-12-04-00468 of
the Tax Rolls of Kabayan Municipal Assessor’s Office. As such, I was in possession
of the owners duplicate original copy of the said Tax Declaration of Real Property
No. 2010-12-04-00468;

2. Since then, I kept the original owner’s copy of ARP No. 2010-12-04-00468 inside our
old family house located at Adaoay, Kabayan, Benguet. Sometime in April 1979, I
mortgaged the said property. As such, I was able to use the same. Nonetheless, I
remained in possession of the original owner’s copy thereof and I still recall that I
placed the same for safekeeping inside the drawer of our cabinet inside our house
after the execution of the mortgage.

3. Recently, when finally we were able to pay or settle the mortgage obligations, we
decided to have the same be cancelled. Unfortunately, when I search for it in cabinet
inside our house where I kept it, I notice that the same is no longer inside the drawer.
I then and there immediately search for it in the premises, but I was not able to locate
the same.

4. Despite diligent efforts exerted, the same proved futile. I therefore consider the said
owner’s original copy of TDRP No. 2010-12-04-00468 irretrievably lost and beyond
recovery.

5. The said tax declaration was not cancelled nor delivered to any person or entity for
the satisfaction of any civil obligation. I am executing this Affidavit to attest to the
truth of the foregoing facts and for all legal intents and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 6th day of June 2017, at La
Trinidad, Benguet, Philippines.

Romeo M. Guinaran
Affiant
Senior Cit. ID No. 1179; Kabayan, Benguet

SUBSCRIBED AND SWORN to before me a Notary Public for and in La Trinidad,

Benguet, Philippines this 6th of June 2017, by the above Affiant, personally known to me by
competent evidence of his identity to be the same person who personally signed before me the
foregoing Affidavit.