AFFIDAVIT OF LOSS

 
 
REPUBLIC OF THE PHILIPPINES)
CITY OF SURIGAO ) S.S. 
                                                     
 
I, MARIA IRIS JANE DEJOLDE., Filipino, of legal age, residing at 05363-A Sampaguita St.,
Kaskag Village, Surigao City, after having been sworn in accordance with law hereby depose
and state:
 
1. I am a holder of a Driver’s License ( Professional) Identification Card
issued by Land Transportation Office ( LTO);
 
2. I lost said Identification Card of January 2, 2018 and that I exerted all
efforts to locate the same and could remember exactly where I placed it
and is condisered lost for all legal purposes;

3. Said Identification Card was not confiscated by any officer of the law by
reason of any violation of any law, ordinance, presidential decree or rules
and regulations of the said Commission; and neither was if offered as
collateral for any loan;
 
          That I am executing this affidavit to attest to the truth of the foregoing
and to request from the Land Transportation Office of Surigao City, a new
issuance of Driver’s License (Professional) Identification Card.
 
IN WITNESS WHEREOF, I have hereunto set my hand this 5th day of January 2018 at Surigao
City, Philippines.
 
              
                   
MARIA IRIS JANE DEJOLDE
        
 
          SUBSCRIBED AND SWORN to before me, this 5th day of January, 2018 in Surigao City,
with affiant exhibiting his CTC No. 10855998 ,
Issued on Jan 03, 2018 at Surigao City, Philippines.
 
 
                                                                                               NOTARY PUBLIC
                                                                                         
 
Doc.  No. :  ________;
Page  No. :  ________;
Book No. :  ________;
Series of 20_______.
 DEED OF ABSOLUTE SALE

 
KNOW ALL MEN BY THESE PRESENTS:

This DEED OF ABSOLUTE SALE is made, executed and entered into by:
 
        CASTIEL DELA ANGELO, of legal age, single, Filipino, and with residence
and postal address at DAPA, SIARGAO ISLANDS, SURIGAO DEL NORTE, hereinafter referred
to as the SELLER 
-AND-
 
        MARIA IRIS JANE DEJOLDE, of legal age, single, Filipino and with residence
and postal address at 05363-A SAMPAGUITA ST., KASKAG VILLAGE, SURIGAO CITY, SDN,
hereinafter referred to as the BUYER.
 
WITNESSETH; 
 
       WHEREAS, the SELLER is the registered owner of a parcel of land with improvements
located at LOT 8 & 9 CARITAS VILLAGE, CAYUTAN, SDN and covered by Transfer Certificate of
Title No. T-65398 containing a total area of TWO HUNDRED FIFTY (250) SQUARE METERS,
more or less, and more particularly described as follows:
 
TRANSFER CERTIFICATE OF TITLE NO. T-65398
 
       "(Insert the  technical description of the property on the title) Example: A PARCEL
OF LAND (Lot 8 & 9 KILOMETER 8, BONIFACIO (LRC) Pcs-13265, being a portion of the
consolidation of Lots 4751-A and 4751-B (LRC) Psd-50533,  Lot 8, Psd-100703, Lot 1, Psd-
150980, LRC Rec. Nos. Nos. N-27024, 51768, 89632, N-11782, N-13466, and 21071 situated
in the CARITAS VILLAGE, BRGY. BONIFACIO, SURIGAO CITY. Bounded on NE., point 4 to 1
by Road Lot 9, on...to the point of beginning; containing an area of (250) square meters more or
less LOCATED INSIDE THE CARITAS VILLAGE, BRGY. BONIFACIO, SURIGAO CITY.
 
       WHEREAS, the BUYER has offered to buy and the SELLER has agreed to sell the above
mentioned property for the amount of (Amount in words) (P 000,000.00) Philippine Currency;
 
       NOW THEREFORE, for and in consideration of the sum of THREE HUNDRED
THOUSAND PESOS (P 300,000.00) Philippine Currency, hand paid by the vendee to the
vendor, the SELLER DO HEREBY SELL, TRANSFER, and CONVEY by way of Absolute Sale
unto the said BUYER, his heirs and assigns, the certain parcel of land together with all the
improvements found thereon, freefrom all liens and encumbrances of whatever nature
including real estate taxes as of the date of this sale.

 
CASTIEL DELA ANGELO               MARIA IRIS JANE Seller                                             
Buyer

 
SIGNED IN THE PRESENCE OF:
 
__________________________               ____________________________
 

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

CITY OF SURIGAO )  SS.

BEFORE ME, a Notary Public for and in the City of SURIGAO,  personally appeared:
 
Name                           CTC Number               Date/Place Issued   
 
CASTIEL DELA ANGELO          10855910           Jan 03, 2018/Surigao City 
 MARIA IRIS JANE DEJOLDE        10855998              Jan 03, 2018/Surigao City
 
Known to me and to me known to be the same persons who executed the foregoing instrument
and acknowledged to me that the same are their free act and voluntary deed.
 
This instrument, consisting of two (2) pages, including the page on which this
acknowledgment is written, has been signed on the left margin of each and
every page thereof by the concerned parties and their witnesses, and sealed
with my notarial seal.
 
WITNESS  MY HAND AND SEAL on this 5th day of January 2018 at Surigao City, Philippines.

Notary Public
 
Doc. No. ........;
Page No. .......;
Book No. .......;
Series of 20__.
 SPECIAL POWER OF ATTORNEY
 
 KNOW ALL MEN BY THESE PRESENTS:
 I, DEAN WINCHESTER, single, of legal age, with residence and postal address at DAPA, SIARGAO
ISLANDS, SURIGAO DEL NORTE do hereby appoint MARIA IRIS JANE Y. DEJOLDE single,
likewise of legal age, with postal address at 05363-A Sampaguita St., Kaskag Village, Surigao City,
SDN as true and legal representative to act for and in my name and stead and to perform the
following acts and deeds:

1. To secure, sign, receive and acknowledge receipt cash,check or en-cash of

my salary with DENR PENRO SDN Office, San Juan, Surigao City.
2. To sign, execute and get any documents relative to the purpose in my
behalf;

HEREBY GRANTING unto the representative full power and authority to execute and
perform all acts necessary or requisite for the purpose as I might or could lawfully do if
personally present, with full power of substitution and revocation, and hereby ratifying and
confirming that my Attorney-in-fact or their susbitute shall lawfully do or cause to be done
under and by virtue hereof.
 
IN WITNESS WHEREOF , WE HAVE HEREUNTO SET OUR HANDS THIS 3rd DAY OF January
2018, AT SURIGAO CITY, PHILIPPINES.
 
 
DEAN WINCHESTER       MARIA IRIS JANE DEJOLDE    
Principal                    Agent /Attorney-In-Fact

Signed in the presence of:

  _____________________________        ___________________________________

A C K N O W L E D G E M E N T 
Republic of the Philippines )
 CITY OF SURIGAO) S.S
 
BEFORE ME, personally appeared:
            
      Name                                    CTC Number                          Date/Place Issued

    DEAN WINCHESTER                           10855997              Jan 03, 2018/DAPA, Surigao

City
MARIA IRIS JANE DEJOLDE               10855998                    Jan 03, 2018/Surigao City
 
Known to me and to me known to be the same persons who executed the foregoing instrument
and acknowledged to me that the same is their free and voluntary act and deed.

WITNESS MY HAND AND SEAL, on the 5th day of January 2018 and at Surigao City,
Philippines.

                                                                                                              
Notary Public                      
 
Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.
 SPECIAL POWER OF ATTORNEY
 
 KNOW ALL MEN BY THESE PRESENTS:
 I, JILLY JEAN CAMILE, single, of legal age, with residence and postal address at DAPA, SIARGAO
ISLANDS, SURIGAO DEL NORTE do hereby appoint VINCENT RECONES single, likewise of legal
age, with postal address at BLK.4 AMAT STREET, SURIGAO CITY, SDN as true and legal
representative to act for and in my name and stead and to perform the following acts and deeds:

To sell, offer for sale, and come to an agreement as to the purchase price and
thereafter to sign for and in my name and receive payment from the sale of our
property more particularly described as follows: LOT 4 AND 5 OF KILOMETER
8, BONIFACIO, SURIGAO CITY, SDN.

HEREBY GRANTING unto the representative full power and authority to execute and
perform all acts necessary or requisite for the purpose as I might or could lawfully do if
personally present, with full power of substitution and revocation, and hereby ratifying and
confirming that my Attorney-in-fact or their susbitute shall lawfully do or cause to be done
under and by virtue hereof.
 
IN WITNESS WHEREOF , WE HAVE HEREUNTO SET OUR HANDS THIS 3rd DAY OF January
2018, AT SURIGAO CITY, PHILIPPINES.
 
 
JILLY JEAN CAMILE       VINCENT RECONES    
Principal            Agent /Attorney-In-Fact

Signed in the presence of:

  _____________________________        ___________________________________

A C K N O W L E D G E M E N T 
Republic of the Philippines )
 CITY OF SURIGAO) S.S
 
BEFORE ME, personally appeared:
            
      Name                                    CTC Number                          Date/Place Issued
JILLY JEAN CAMILE          10855997              Jan 03, 2018/DAPA, Surigao
VINCENT RECONES              10855998                    Jan 03, 2018/Surigao City
 
Known to me and to me known to be the same persons who executed the foregoing instrument
and acknowledged to me that the same is their free and voluntary act and deed.

WITNESS MY HAND AND SEAL, on the 5th day of January 2018 and at Surigao City,
Philippines.

                                                                                                              
Notary Public                      
 
Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.
 DEED OF SALE OF MOTOR VEHICLE
 
 
KNOW ALL MEN BY THESE PRESENTS:
 
          That I, MARIA IRIS JANE DEJOLDE, Filipino, of legal age, a resident of
05363-A SAMPAGUITA ST., KASKAG VILLAGE, SURIGAO CITY, SDN, is the lawful
owner of a certain motor vehicle which is more particularly described as follows:  
MAKE                   : ISUZU C.R. NO.                            : 17849800-5
SERIES                : NHR SERIAL/CHASSIS NO.      :
AHPNHRPAB56EL8606811
TYPE OF BODY     : 4JB1-8401168P PLATE NO.                        :MIJ009
YEAR MODEL        : 2013 O.R. NO. : 00000069780099
COLOR : BLUE

           That for and in consideration of the sum of Forty Thousand

(P40.000.00) PESOS, Philippine Currency, receipt whereof is hereby acknowledged to
my entire satisfaction, I hereby sell, transfer and convey by way of Absolute Sale
unto CROWLIE DOS UNO, Filipino, of legal age, and resident of Blk.4 Espina St.,
Surigao City, SDN, the above described motor vehicle, free from all liens and
encumbrances.
 
          IN WITNESS WHEREOF, we have hereunto affixed our hands this____ day of
_______________ at ________________.
 
 
CROWLIE DOS UNO                MARIA IRIS JANE DEJOLDE
Vendee                                              Vendor
 
Signed in the presence of:
  
_____________________________                 ______________________________
 
ACKNOWLEDGEMENT
 
Republic of the Philippines )
CITY OF SURIGAO ) S.S
 
BEFORE ME, personally appeared:
 
              Name                              CTC Number            Date/Place Issued
 
             MARIA IRIS JANE DEJOLDE         10855998            Jan 03,2018/Surigao
City
     CROWLIE DOS UNO                    10855762             Jan 03,2018/Dapa, SDN
 
Known to me and to me known to be the same persons who executed the foregoing
instrument and acknowledged to me that the same is their free and voluntary act and
deed.
 
WITNESS MY HAND AND SEAL, on the date and place first above written.
                                                                  
                                                                                     Notary Public
 
Doc. No.______;
Page No. ______;
Book No.______;
Series of 20___.
DEED OF DONATION
 
 
KNOW ALL MEN BY THESE PRESENTS:

That I, MARIA IRIS JANE DEJOLDE of legal age, single, with postal address at
05363-A Sampaguita Street, Kaskag Village, Surigao City, SDN hereinafter referred to
as the DONOR, and SAM WINCHESTER, likewise of legal age, single, with postal
address at 07020 San Juan, Surigao City, SDN hereinafter called the DONEE,
witnesseth:

That the DONOR is the registered owner of a parcel of land, more particularly
described as follows:
Lot 7 Block 1 with an area of One Hundred Fifty (150) square meters, covered by
Transfer Certificate of Title No. N-199470 of the Registry of Deeds of Surigao City
situated in Palmera Homes Subdivision, Brgy. Poctoy, Surigao City, SDN

That the DONEE is a cousin of the DONOR, who has lovingly dedicated five (5) years of
his life as the latter's personal caregiver and companion;

That FOR AND IN CONSIDERATION of the DONEE'S trust, devotion and affection
shown to the DONOR, and as an act of gratitude and liberality on his part, the
DONOR hereby voluntarily GIVES, TRANSFERS, and CONVEYS by way of donation,
unto the said DONEE, his heirs and assigns, the above described property, together
with all the improvements found thereon, free from all liens and encumbrances;
 
That the DONOR affirms that this donation is not made with intent to deceive his
creditors, and that he has reserved for himself sufficient funds and property;

That the DONEE hereby accepts and receives this donation made in his favor by the
DONOR, and hereby manifests his gratefulness for the latter's generosity.

IN WITNESS WHEREOF, both the DONOR & DONEE have hereunder subscribed their
names this 5th day of January 2018 at Surigao City, Philippines.
 
 
MARIA IRIS JANE DEJOLDE         SAM WINCHESTER
DONOR                                                  DONEE 
WITNESSES:
 
_____________________________          ______________________________
  
ACKNOWLEDGEMENT
 
Republic of the Philippines)
City of Surigao) S.S
 
BEFORE ME, a notary for and in the City of Makati, personally appeared:
Name                 CTC Number                    Date/Place Issued     
MARIA IRIS JANE DEJOLDE           10855998               Jan 3, 2018/Surigao City

known to me and to me known to be the same persons who executed the foregoing
Deed of Donation and acknowledged to me that the same is their free and voluntary
act and deed.
 
WITNESS MY HAND AND SEAL, on the date and place first above written.
Notary Public
Doc. No._____;
Page No. _____;
Book No._____;
Series of 20___.