REPUBLIC OF THE PHILIPPINES )

PROVINCE OF NORTHERN SAMAR ) S.S.

MUNICIPALITY OF CATARMAN )

AFFIDAVIT OF LOSS

I, EMMANUEL SANTILLAN, a Filipino Citizen, of legal age, and a

resident of Brgy. Poblacion, Lope De Vega, Northern Samar, after having been
duly sworn to in accordance with the law do hereby depose and state:

1. That I am an heir of Lilia Ano Palloc and a sibling of Fe Ano Santillan;

2. That my sister Fe Ano Santillan gave me Original Certificate of Title

No. P-20100 under the name of Adelina Yabao for safekeeping.
Unfortunately, sometime during December 15, 2014 Typhoon Nona
struck Northern Samar which immensely affected the Municipality of
Mapanas where I was residing back then. As a result, all of my
personal properties including the aforementioned Original Certificate
of Title perished;

3. That diligent efforts were exerted to locate and retrieve the said title
but it was not found. Hence, for all legal intents and purposes the
said title is hereby deemed lost and beyond recovery;

4. That I am executing this Affidavit of Loss in support of the Petition for

Re-issuance of Title filed at the Regional Trial Court of Catarman,
Northern Samar Branch 20 with Land Registration Case No. 427 and
for whatever legal intent this affidavit may rightfully serve.

Affiant further sayeth naught.

IN WITNESS THEREOF, I have hereunto set my hand this 29 th day of

April 2021, at Catarman, Northern Samar, Philippines.

EMMANUEL SANTILLAN
Affiant
I.D._____________________

SUBSCRIBED AND SWORN to before me this 29th day of April 2021, at

Catarman, Northern Samar, affiant exhibiting to me competent proof of his
identity through his identification card as stated above.

Doc. No._____
Page No._____
Book No._____
Series of 2021