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Republic of the Philippines )

City of Tarlac )


I, MERCEDES L. SUBA, of legal age, widow, and a resident of Barangay Maliwalo,

Tarlac City, after being duly sworn according to law, do hereby depose and state that:

1. ROGELIO SOSA BASCO is the registered owner of a parcel of land with

the Transfer Certificate Title No. 043-2011002215 and Transfer
Certificate Title No. 043-2010006741 situated in Barangay Sepung
Calsada, Aguso and Tariji, Tarlac City ***containing an area of ONE
HUNDRED TWENTY NINE square meters, more or less, respectively;

2. He donated the said parcels of land to his daughter ARMEL BASCO CARPIO;

3. Sometime on June 2018, the original copy of the said Deed of Donation with BIR
CAR No. eCR201700416761 and Ecr201700416762 dated May 31, 2018 could
not be found;

4. Despite diligent search and best efforts, I failed and, to this day, still fail to locate
and recover the said Deed of Donation such that I now believe that the said Deed
of Donation is lost beyond recovery;

5. Wherefore, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and for whatever legal purposes that this may serve;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 10th day of July
2018 at Tarlac City, Philippines.


SUBSCRIBED AND SWORN TO before me this 10th day of July 2018 at Tarlac City,

Doc. No. __________

Page No. __________
Book No. __________
Series of 2018 .