REPUBLIC OF THE PHILIPPINES)

PROVINCE OF ILOCOS SUR )

CITY OF VIGAN)

AFFIDAVIT OF LOSS
Edwin Navarete Romo, of legal age, Filipino, married and a resident of San Sebastian, San
Vicente Ilocos Sur after being sworn in accordance with law, hereby depose and state THAT:

1. My deceased aunt, Arsenia Navarete was a beneficiary of the Comprehensive Agrarian

Reform Law Program by the government. She was issued a Original Certificate of Title No. E.
O No. 6757 over the parcel of (Copy of the Transfer Certificate of Title No. CLOA-28276 is
hereto attached and marked as Annex “A”)
2. The said Title was under my custody when my aunt died on March 24, 2001;
3. Sometime in 2019, when I decided to transfer the land under my name, because finally I had
the time and opportunity to do so, I’ve discovered that the Original Owner’s Duplicate Copy of
E.O No 6757 was missing
4. All diligent efforts I’ve exerted to locate 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 Original Certificate Tittle No. E.0
6757 of the Registry of Deeds of Ilocos Sur was never mortgaged, sold, conveyed, disposed of,
or encumbered, to any other person or entity. I certify and confirm further that said document
was neither confiscated nor relinquished in favor of, any government entity agency, or authority;
6. I attest to the truth of the foregoing statements to the best of my own personal knowledge and
based on authentic documents or records. I am executing this Affidavit of Loss to support my
application for a new owner’s duplicate copy of Transfer Certificate of Title No. E.0 6757as well
as for all lawful intents and purposes it may serve.

IN WITNESS WHEREOF, I set my hand this 27th day of December 2021 at Vigan City,
Philippines.

EDWIN NAVARETE ROMO

Affiant

SUBSCRIBED AND SWORN to before me this 27TH day of December, 2021 at Vigan City.
Affiant has exhibited to me his _________________bearing his picture and signature as
competent proof of her identity.