REPUBLIC OF THE PHILIPPINES) SS

CITY OF DUMAGUETE)
AFFIDAVIT OF LOSS
I, _________________, Filipino, of legal age and a resident of
_______________________, after being sworn in accordance with law, hereby
state and declare:
That I am the true owner of a parcel of land situated in
___________________ and covered by the Transfer Certificated of Title No.
__________________;
That I diligently kept my Torrens Title in a file and kept it inside a locked
cabinet;
That I wanted to sell the property and retrieved my owners copy of the
title. unfortunately, the title was somehow misplaced somewhere else
during a recent house renovation;
The Owners Duplicate Copy of
____________ is now completely lost;

Transfer

Certificate of

Title no.

That I am executing this affidavit to attest to such loss in connection with

my desire to be issued a New Owners Duplicate copy of the said
certificate by the Office of the Register of Deeds of the City of
Muntinlupa;
FURTHER I SAY NONE.
__________________________
Landowner-Affiant

SUBSCRIBED AND SWORN TO before me this _________________ day of

_________________ in ____________________.

NOTARY PUBLIC

Doc. No. ___

Page No. ___

Book No. ___
Series of _______