Republic of the Philippines )

) S.S.
)
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AFFIDAVIT OF LOSS

I, CORAZON BARCIAL, US Citizen, of legal age,

single, a resident of 223 North Lamb Boulevard,
Unit B. Las Vegas, Nevada, after being duly sworn
to in accordance with law, hereby depose and state
that:

1.I am the purchaser of that parcel of land

located at San Carlos Hts., Tayuman,
Binangonan, Rizal, containing the area of
Four Hundred Fifty-Four (454) Square
Meters covered by Transfer Certificate of
Title No. 334527 of the Registry of Deeds
of Rizal, more or less.

2.I purchased the said property in 1973 when

I was still a Filipino Citizen.

3.It came as a shock, that on the __ day of

_______, 2019, more or less, the title
over said property has gone missing from
my residence in ______________________.
All diligent efforts I exerted to locate
and retrieve it were in vain; hence for
all legal intents and purposes it is now
deemed lost and beyond recovery.

4.I certify and confirm that the parcel of

land covered by Transfer Certificate of
Title No. 334527 of the Registry of Deeds
of Rizal was never mortgaged, sold,
conveyed, disposed of, or confiscated nor
relinquished in favor of, any government
entity, agency, or authority.

5.I attest to the truth of the foregoing

statements to the best of my own personal
knowledge and based on authentic documents
or records.

6.I am executing this Affidavit of Loss to

support my application for a Certified
 True Copy of Transfer Certificate of Title
No. 334527 as well as for all lawful
intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my

hand this _____________ at
_______________________________________.

CORAZON BARCIAL
Affiant

SUBSCRIBED AND SWORN to before me, this ___ day

of __________ 2018, in the _______________________,
affiant exhibited to me her ________________ with
I.D. No. __________ issued at
_______________________ on ___ day of ____________.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2019;

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