REPUBLIC OF THE PHILIPPINES )

PROVINCE OF ISABELA ) ss.

MUNICIPALITY OF CABAGAN )

AFFIDAVIT OF LOSS

I, ARIEL A. CALLUENG, of legal age, maried, Filipino and resident of Brgy. Luquilu,
Cabagan, Isabela after having been duly sworn to according to law hereby depose and state:

1) That I am the same person executing this affidavit;

2) That I have in my possession Deed of sale and Official Receipt or Certificate of

Registration;

3) That I placed the said Deed of sale and Official Receipt or Certificate of
Registration inside my filing cabinet for safe keeping;

4) That, on August 24 2018, while I was cleaning the said filing cabinet, I noticed that
my Deed of sale and Official Receipt or Certificate of Registration were missing;

5) That I exerted diligent efforts to locate the same, but proved futile;

6) That it was considered lost due to excusable negligence and mere inadvertence;

7) That I am executing this affidavit in order to attest the truthfulness of all the
foregoing statements and for all lawful intent and purposes it may serve.
IN WITNESS WHEREOF, I hereunto set my hand this 28th day of April 2022 at
Cabagan, Isabela.

ARIEL A. CALLUENG
Affiant
Valid ID No. ________________
Issued by: _________________

SUBCRIBED AND SWORN TO BEFORE ME this 28th day of April 2022 in

Cabagan, Isabela, Philippines affiant exhibiting to me his valid id written below his name as
proof of his identity.

Doc No. _____ ;

Page No. _____;
Book No. ______;
Series of 2022.