REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SURIGAO DEL NORTE)S.S.

CITY OF SURIGAO )

AFFIDAVIT

I, ENRIQUITA C. SALABE, of legal age, Filipino, a resident of Claver,

Surigao del Norte, after having been duly sworn to according to law
hereby depose and state:

That we are the legal heirs of the late

That the Certificate of Registration (CR) of the abovementioned

motorcycle without sidecar, issued by Land Transportation Office (LTO),
Surigao City was lost while in my possession;

That the said CR was lost in my possession due to Super Typhoon

“Odette” occurred last December 16, 2021;

That due to the abovementioned reason, I consider the said CR as

lost and beyond recovery;

That I am executing this affidavit to attest to the truthfulness of

the foregoing facts and circumstances and for whatever legal purpose/s
it may serve best;

IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day

of September, 2023 at Surigao City, Surigao del Norte.

ENRIQUITA C. SALABE
Affiant

SUBSCRIBED AND SWORN to before me this 5 th day of September,

2023 at Surigao City, Surigao del Norte, Philippines.

DOC NO. _____;

PAGE NO. _____;
BOOK NO. _____;
SERIES of _____.