REPUBLIC OF THE PHILIPPINES )

ILOILO CITY, ILOILO ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, DRA. EVA MABUNAY-GUSTILO, of legal age, Filipino,

widowed, and a resident of Doña Aurora Subdivision, Iloilo City, Iloilo,
Philippines, after being sworn in accordance with law, hereby disposes
and states the following:

1. That I am the registered owner of the following lots:

a. Lot No. 3819-A-8 covered by Transfer Certificate of
Title No. T-210,130, with an area of Two Thousand
Four Hundred Forty Seven (2,447) square meters, more
or less, located in Brgy. Lanag Santa Barbara, Iloilo,
Philippines;
b. Lot No. 3819-A-7 covered by Transfer Certificate of
Title No. T-210,129, with an area of Three Thousand
Two Hundred Eighty Eight (3,288) square meters, more
or less, located in Brgy. Lanag Santa Barbara, Iloilo,
Philippines; and,
c. Lot No. 3819-A-6 covered by Transfer Certificate of
Title No. T-210,128, with an area of Three Thousand
Six Hundred Ninety Three (3,693) square meters, more
or less, located in Brgy. Lanag Santa Barbara, Iloilo,
Philippines;

2. That I had the following titles kept in one of the secured drawers
in my former home in Molo, Iloilo City, Philippines;

3. That sometime in August 2011, I moved with my son Dr.

Gerardo M. Gustilo, to my current residence and on the process
of moving, misplaced and lost the original duplicate of Owner’s
Copy of the following land titles:
a. Transfer Certificate of Title No. T-210,130;
b. Transfer Certificate of Title No. T-210,129; and,
c. Transfer Certificate of Title No. T-210,128;

4. That the above parcels of land are currently subject of Contract

of Sale with the persons listed below and that I am executing
this affidavit in order to apply for a new owner’s duplicate copy
to process said sale;

5. I certify and confirm that the above parcels of land covered by

the above-listed land titles of the Registry of Deeds of Iloilo was
never mortgaged, sold, conveyed, disposed of, or encumbered,
to any other person or entity aside from the above mentioned
Contract of Sale. I certify and confirm further that said document
 was neither confiscated nor relinquished in favor of, any
government entity agency, or authority;

6. That despite diligent efforts to look for the above-listed land

titles original duplicate of Owner’s Copy, I could no longer locate
the same; and,

7. 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. T-210,130, T-210,129, and T-210,128.

IN WITNESS WHEREOF, I set my hand this ____ day of

_____________ 2019 at Iloilo City, Philippines.

EVA MABUNAY-GUSTILO
Affiant
Competent Evidence of
Identity
ID:____________________

SUBSCRIBED and SWORN TO before me on the date and at the place

indicated below. The affiant exhibited to me his competent evidence of
identity as indicated above.

Signed this ____ of ___________ 2019 at Iloilo City, Philippines.

WITNESS MY HAND AND SEAL.

NOTARY PUBLIC

Doc. No.: ____;

Page No.:____;
Book No.:____;
Series of 2019.