Republic of the Philippines)

Tuguegarao City, Cagayan ) S.S

AFFIDAVIT OF LOSS

That I, CLARITA F. MOLINA of legal age, Filipino and a resident of Matucay

Allacapan, Cagayan after having sworn to in accordance by law do hereby depose and say;

1. That I am the vendee of a parcels of land situated in Cabaggaoan Allacapan, Cagayan

designated as Lot No. 647 of the Allig Plains Public Land Subdivisions, Pls-64, cadastral
Case No. N-12, L.R.C Cadastral Record No. N-401 and Lot No. 1998 of the Allig Plains
Public Subdivision, Pls-64, Cadastral Case No. N-12, L.R.C cadastral record No. N-401
embraced under Original Certificate of Title No. O-1231 (S);

2. That during the process of transfer of ownership, the said Original Certificate of Title No.
O-1231 (S) duplicate copy is lost as the same might have been misplaced among other
files nor submerged by flood during the typhoons that devastated the province;

3. That despite assiduous and earnest efforts to locate said duplicate copy of Original
Certificate of Title No. O-1231 (S) but the same prove futile;

4. That said duplicate copy of Original Certificate of Title No. O-1231 (S) is not mortgaged
nor given as a collateral or security of any obligation to any bank or financial institution;

5. That I am executing this affidavit in good faith;

IN WITNESS HEREOF, I hereby unto set my hand this 15 th day of May 2023 in
Tuguegarao City, Cagayan.

CLARITA F. MOLINA
Affiant

SUBSCRIBED and SWORN to before me this _____ day of ______________ in

Tuguegarao City, Cagayan.

Doc No.
Page No.
Book No.
Series of 2023