Republic of the Philippines)

City of Butuan ) S.S.

AFFIDAVIT OF LOSS

I, CAROLINA BARRUCA MANZANARES, 74 years old, Filipino, widow, and a

resident of Purok-Petchay, Barangay Golden Ribbon, Butuan City, Philippines, after having been
duly sworn to in accordance with law, depose and state:

1. That I am the biological daughter of the late FRANCIS BARRUCA SR.

owner of a parcel of lot consisting of Two Hundred Sixty-Six (266) square meters
as represented by Jesus Barruca particularly described as follows:
 Katibayan ng Orihinal na Titulo Bilang P-4238
Location: Barangay Tandag Sora, Butuan City, Agusan del
Norte;

2. That my father handed to me the said document for safekeeping however,

when I tried to locate it just recently, the same could no longer be found;

3. That despite diligent search and efforts to locate it, I could not find the
same such that I now believe that said document is now lost beyond recovery;

4. That I certify that the parcel of land covered by Katibayan ng Orihinal na

Titulo Bilang P-4238 of the Registry of Deeds, Butuan City was never mortgaged,
sold, conveyed, disposed of, or encumbered, to any other person or entity;

5. That I certify and confirm further that the said document was neither
confiscated nor relinquished in favor of, any government entity agency, or
authority; and

6. That I am executing this Affidavit of Loss to attest to the veracity of the

foregoing and to support my Petition for the issuance of new owner’s duplicate
Transfer Certificate of Title with the Registry of Deeds of Butuan City and for
whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ________ at

Butuan City, Philippines.

CAROLINA BARRUCA MANZANARES

Affiant
OSCA ID No.: 23670095

SUBSCRIBED AND SWORN TO BEFORE ME this _____________ at Butuan City,

Philippines.

Doc. No. ________;

Page No. ________;
Book No. _________;
Series of 2022.