REPUBLIC OF THE PHILIPPINES)

CITY OF CABANATUAN )S.S.

X----------------------------X

AFFIDAVIT DISCREPANCY

I, MARY GRACE MEMPIN ESPINOSA, of legal age, single, Filipino and a resident of
Brgy. Poblacion, San Isidro, Nueva Ecija, after having been duly sworn to in accordance with law
hereby depose and states:

1. That in TCT NO. 041-2014006558 situated at Barrio of Niyugan, Municipality of

Jaen, Province of Nueva Ecija, with an area of ONE HUNDRED FORTY TW (142)
SQUARE METERS, my name was erroneously recorded as MARY GRACE
MEMPIN ESPINOZA;

2. That my true and correct name is MARY GRACE MEMPIN ESPINOSA;

3. That MARY GRACE MEMPIN ESPINOZA as per TCT NO. 041-2014006558

and MARY GRACE MEMPIN ESPINOSA, pertains to one and the same person;

4. That I have executed this Affidavit to rectify and affirm and attest the fact that
regarding my true and correct name MARY GRACE MEMPIN ESPINOSA.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 13th day of September
2016 here at Cabanatuan City.

MARY GRACE M. ESPINOSA

Affiant

SUBSCRIBED AND SWORN to before me this 13th day of September 2016 here at
Cabanatuan City.

Doc. No._______
Page No._______
Book No._______
Series of 2016.
REPUBLIC OF THE PHILIPPINES)
CITY OF CABANATUAN )S.S.
X----------------------------X

AFFIDAVIT OF LOSS

I, MARY GRACE MEMPIN ESPINOSA, of legal age, single, Filipino and a resident of
Brgy. Poblacion, San Isidro, Nueva Ecija, after having been duly sworn to in accordance with law
hereby depose and states:

1. That I am the registered owner of one parcel of land with TCT NO. 041-2014006558
situated at Barrio of Niyugan, Municipality of Jaen, Province of Nueva Ecija, with an
area of ONE HUNDRED FORTY TW (142) SQUARE METERS;

2. That on December 16, 2015, typhoon NONA hits Nueva Ecija and our place was
flooded due to typhoon, our cabinet submerged where my important documents was
placed. The said TCT NO. 041-2014006558 lost despite of the diligent effort to
locate the same but to no avail;

3. That I executed this affidavit to attest to the truth of the foregoing and hereby
respectfully request for the replacement of the said lost item.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 13th day of September
2016 here at Cabanatuan City.

MARY GRACE M. ESPINOSA

Affiant

SUBSCRIBED AND SWORN to before me this 13th day of September 2016 here at
Cabanatuan City.

Doc. No._______
Page No._______
Book No._______
Series of 2016.