Republic of the Philippines )

Municipality of _________ )SS.

Province of Ilocos Sur )

JOINT AFFIDAVIT OF LOSS

Re: Owner’s Copy of OCT No. ________

We, Spouses A AND B, both of legal age, Filipinos, husband and

wife, respectively, and residents of ________, after having been sworn to in
accordance with law, depose and states:

1. That we are the vendee of a registered land covered by OCT No.

_____, which parcel of land is identified as Lot no. _______ located
in _____________.
2. That such certificate of title was surrendered to us by the vendor
during its sale and since then, it was kept inside a cabinet in our house
for safekeeping.
3. However, now that we are looking for it, it can no longer be found.
All diligent efforts we exerted to locate and retrieve it were in vain,
hence for all legal intents and purposes, the abovementioned title was
now deemed lost and beyond recovery.
4. The subject owner’s copy of OCT No. _______ was not offered as
collateral to secure the payment of any loan, neither was it confiscated
nor relinquished in favor of any government entity or authority.
5. That we are executing this Affidavit to attest to the truthfulness of the
foregoing and for all legal intents and purposes.

In Witness Whereof, we have hereunto affixed our signatures this

_____________ at _________.

______________________________________
Affiant Affiant
ID No. _____________ ID No. _____________
Issued on __________ Issued on __________
at _________________ at _________________

SUBSCRIBED AND SWORN TO, Before me, this __________ at

_____________, the affiants with their competent evidence of identities.