REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SURIGAO DEL NORTE)S.S.

CITY OF SURIGAO )

AFFIDAVIT OF LOSS

I, LILIBETH M. BRABANTE, of legal age, Filipino, single, a

resident of Brgy. Cagniog, Surigao City, Surigao del Norte, after having
been duly sworn to according to law hereby depose and state:

That I am one of the heirs of the late EUSTAQUIO CORBETA, the

declared owner of a parcel of land with Transfer Certificate of Title No. T-
5102 situated at Brgy. Luna, Surigao City, Surigao del Norte;

That the abovementioned property has a Transfer Certificate of

Title (TCT) which was lost last 2013;

That despite of my diligent efforts to locate the said TCT, I could

not find the same such that I have good reason to believe the same as
now lost and beyond recovery;

That the loss of the said TCT was not due to any negligence, willful
act, or omission on my part;

That I am executing this affidavit to attest to the truthfulness of

the foregoing facts and circumstances and for whatever legal purpose/s
it may serve best;

IN WITNESS WHEREOF, I have hereunto set my hand this 11 th day

of August, 2023 at Surigao City, Surigao del Norte.

JEANNICA LITO ALABAT

Affiant

SUBSCRIBED AND SWORN to before me this 11th day of August,

2023 at Surigao City, Surigao del Norte, Philippines.

DOC NO. _____;

PAGE NO. _____;
BOOK NO. _____;
SERIES of _____.
REPUBLIC OF THE PHILIPPINES )
PROVINCE OF SURIGAO DEL NORTE)S.S.
CITY OF SURIGAO )

AFFIDAVIT OF LOSS

I, CHLAIRE DIMPLE C. BUYSER, of legal age, Filipino, single, a

resident of Sta. Cruz, Placer, Surigao del Norte, after having been duly
sworn to according to law hereby depose and state:

That I am a member of Philippine Health Insurance Corporation

(PhilHealth);

That the PhilHealth issued me an Identification Card (ID);

That the said ID was lost during my travel to Davao last May,
2023;

That despite of my diligent efforts to locate the said ID, I could not
find the same such that I have good reason to believe the same as now
lost and beyond recovery;

That I am executing this affidavit to attest to the truthfulness of

the foregoing facts and circumstances and for whatever legal purpose/s
it may serve best;

IN WITNESS WHEREOF, I have hereunto set my hand this 20 th day

of July, 2023 at Surigao City, Surigao del Norte.

CHLAIRE DIMPLE C. BUYSER

Affiant

SUBSCRIBED AND SWORN to before me this 20 th day of July,

2023 at Surigao City, Surigao del Norte, Philippines.

DOC NO. _____;

PAGE NO. _____;
BOOK NO. _____;
SERIES of _____.