REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO )

PROVINCE OFPAMPANGA ) S.S
x-----------------------------------------------x

AFFIDAVIT OF LOSS TITLE

We, SPOUSES LUIS C. SAGUM AND JEAN M. SAGUM, both of legal age, Filipino
citizens, married and both resident of Purok 6, Barangay Guemasan, Arayat, Pampanga, after
being having been duly sworn under oath in accordance with law hereby voluntarily depose and
say:
1. That we are the registered owner of a parcel of land situated in the barrio of
Guemasan, Barangay Arayat, Province of Pampanga with TCT . No. 042-2013002526 ,
issued by the Register of Deeds of San Fernando, Pampanga, containing an area of
three hundred thirty square meters (330) sq.,

2. That on March 9, 2019, we discovered that the title of our lot registered under our
names and placed inside our vault was missing;

3. That on the same day we discovered a letter wrote by our daughter Joanna
Lorrraine Masangkay Sagum wherein she confessed that she took the TCT No. No. 042-
2013002526 without our consent;

4. That until now, despite our diligent efforts we are not able to recover the said title;

5. That we are executing this affidavit to attest to all the above facts, and to request
the Honorable REGISTER OF DEEDS of San Fernando, Pampanga to issue the new
owners duplicate of Title No. TCT. No. 042-2013002526 registered under our names;

IN WITNESS WHEREOF, We have here unto set our hands this ____________th day of
_____________________, _______________ at San Fernando, Pampanga.

LUIS C. SAGUM JEAN M. SAGUM

AFFIANT AFFIANT
OSCA ID NI: 01361 VIN: 1420-0208A-J2860JMS20001-5
Issued at Arayat, Pampanga
On Sept. 07, 2017

SUBSCRIBED AND SWORN to before me this __________th day of

__________________, _____________ Affiants who exhibited to me their compentent evidence
of identities indicated below their name and signature .

Doc. No. _________;

Page No. _________;
Book No. ________;
Series of 2019;