AFFIDAVIT OF LOSS

Republic of the Philippines}

City of _______________ }S.S.

I, ROMMEL M. FRANCISCO, a Filipino citizen, of legal age, married and

a resident of Anahaw Road, Pilar Village, Las Pinas City, after having been
sworn in accordance with law, hereby depose and state that:

1. I am the first-born son and legitimate child of Sps. Dominador R.

Francisco and Amelia M. Francisco, both deceased;

2. Yesterday, 23 August 2020, I discovered the loss of the Owner’s

Original Copy of TCT No. __________________ issued by the
Register of Deeds of Bulacan, Meycauayan Branch, and registered
in the names of my parents, Sps. Dominador R. Francisco and
Amelia M. Francisco, and despite diligent effort to search for the
same, I could no longer locate the said Owner’s Original Copy;

3. I am executing this affidavit to attest to the truth of the foregoing and

for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of

August 2020 at _________________ City.

_____________________
ROMMEL M. FRANCISCO

SUBSCRIBED and SWORN to before me this this ____ day of August

2020 at _________________ City, after the affiant exhibited to me his Driver’s
License with No. ______________ and expiry date on ____________________.

Notary Public

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2020

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