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REPUBLIC OF THE PHILIPPINES

FIRST JUDICIAL REGION
REGIONAL TRIAL COURT
________
_____________

IN RE: PETITION FOR THE REISSUANCE OF A

NEW OWNER’S CUPLICATE COPY OF
__________ IN LIEU OF THE LOST ONE,

ABC,
Petitioner,
-versus-
Recons. Case No. _______
THE REGISTER OF DEEDS OF ILOCOS SUR,
Respondent.
x----------------------------------------------x
                            
PETITION

COMES NOW, Petitioner, by and through the undersigned counsel

and unto this Honorable Court, respectfully alleges that:

1.                The Petitioner is of legal age, Filpino, married, and a

resident of _________, where he may be served with court processes;
whereas nominal respondent, the Register of Deeds of Ilocos Sur
which is located at Zone V, Quirino Blvd., Bantay, Ilocos Sur, is
impleaded in its capacity as custodian of titles to land situated in the
Province of Ilocos Sur;

2.                The Petitioner is the registered owner of the land covered

and was issued with the owner’s copy of Original Certificate of Title No.
____ by the Registry of Deeds for the Province of Ilocos Sur, which parcel
of land is particularly described as follows:

   Original Certificate of Title No. ______

A parcel of land xxxx

          A Copy (electronic) of Original Certificate of Title No. _______ is

hereto attached as Annex “A”.

3. That petitioner was in possession of the owner’s duplicate copy

of the title before it was lost. Petitioner as he usually does with all of his
important documents, had placed it in his cabinet at home for safekeeping.
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5.      However, after diligent search in the drawer of his cabinet, the
owner’s copy of the Original Certificate of Title No. _________, the same
could not be found;

6.      The Petitioner exerted all efforts to look and determine the
whereabouts of the said certificate of title but despite these efforts, the
Petitioner still failed to locate the said certificate and apparently it was
misplaced and deemed lost;

7.      Consequently, the Petitioner executed an Affidavit of Loss,

which was registered with the Register of Deeds for Ilocos Sur and
annotated at the Original Certificate of Title No. _____ in the possession of
said Office, a copy of the Affidavit of Loss is hereto attached as Annex
“B” and made as an integral part hereof;

8. The subject owner’s duplicate copy of OCT No. ______ was

not offered as collateral to secure the payment of any loan, and that
petitioner is in possession of the property covered by the lost certificate of
title.

WITNESSES and DOCUMENTS TO BE PRESENTED

The petitioner will testify on the petition and will present the
following:
a) The Petition and his Judicial Affidavit
b) The (electronic) copy of OCT No. _______
c) Affidavit of Loss executed by petitioner
d) His Identification Document or any competent evidence of his
identity.

PRAYER

WHEREFORE, premises considered, it is respectfully prayed of the

Honorable Court that after due notice and hearing, a decision be rendered by
this Honorable Court directing and authorizing the Register of Deeds of
Ilocos Sur to cause the issuance of a new Owner’s Duplicate Copy of OCT
No. _______ with like faith and integrity as the lost certificate of title for all
legal intents and purposes. It is likewise prayed that the lost owner’s copy be
ordered cancelled and declared to be of no force and effect.

          Other reliefs and remedies as may be deemed just and equitable under
the premises are likewise prayed for.
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          RESPECTFULLY SUBMITTED. __________________.

ATTY.

Republic of the Philippines )

Province of Ilocos Sur          ) S.S.

VERIFICATION WITH CERTIFICATION OF

NON-FORUM SHOPPING

          I, _________, of legal age, married and with postal address

at _______, after having been duly sworn to in accordance with law do
hereby depose and state that:

I am the Petitioner in the above-entitled case and I have caused the

preparation of the foregoing Petition. That the allegations therein are true
and correct of my own personal knowledge based on authentic documents on
record;

I have not heretofore commenced any other action or proceeding

involving the same issues in the Supreme Court, the Court of Appeals, or
any other tribunal or agency as are raised in this case;

To the best of my knowledge, no such action or proceeding is pending

in the Supreme Court, the Court of Appeals or any tribunal or agency; and

If I should thereafter be aware or learn that a similar action or

proceeding has been filed or is pending before the Supreme Court, the Court
of Appeals or any other tribunal or agency, I will undertake to report this
fact within five (5) days there from to this Court.

___________________________________
AFFIANT

SUBSCRIBED AND SWORN to before me this

________________, affiant personally appeared and is personally known to
me.