REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SAMAR...........) SS
CITY OF CATBALOGAN.........)

AFFIDAVIT OF LOSS

I, MARILOU R. LATORRE, of legal age, single, Filipino and with residence at

Villareal, Samar, after having been duly sworn to in accordance with law do hereby
depose and state that:

1. I am the registered and lawful owner of a motor vehicle with Official

Receipt No. 000201229674076, issued on 03 October 2012 February 2006 and Certificate
of Registration No. 00000001706586 by LTO Catbalogan District Office Manila, NCR,
and more particularly described as follows:
MV File No. : 1304-00000293819;
MAKE/SERIES : TOYOTA/HIACE COMMUTER;
BODY TYPE : VAN;
ENGINE No. : 2KD5882037
CHASSIS NO. : JTFJS02P305015269
PLATE No. : 084410

2. Unfortunately, in 18 January 2018, the Certificate of Registration (C.R.)

and Official Receipt (OR) of the above-described motor vehicle was misplaced, I then
tried and exerted efforts to locate said C.R and OR. in every corner of places in our house
where I probably placed it, but to no avail and the same proved futile such that after a
reasonable time that elapsed, I now consider it lost for all intents and purposes;

3. This statement of loss is made in good faith and never intended to defraud
the Land Transportation Office (LTO) and third persons, and said Certificate of
Registration (C.R.) and Official Receipt (OR) was never confiscated from me by said
agency for violation of traffic laws, rules and regulations but only due to the reason
herein set forth;

4. I am executing this statement to attest the truth of all the foregoing and to
request for a new/duplicate copy of said Official Receipt (OR), and Certificate of
Registration (C.R.), and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 20th day of

November 2023 at Catbalogan City.

MARILOU R. LATORRE
Affiant

SUBSCRIBED AND SWORN to before me this 20th day of November 2023 at

Catbalogan City, affiant exhibiting to me his Driver’s License ID No. N04-90-133322.

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFIDAVIT OF LOSS
I, EBEL E. OBOR, of legal age, married, Filipino and with residence at Brgy. Buray,
Paranas, Samar, after having been duly sworn to in accordance with law do hereby
depose and state that:

5. I am the registered and lawful owner of a motor vehicle with Official

Receipt No. 597125410, issued on 22 September 2014 by LTO Catbalogan District
Office, Catbalogan City, Samar and more particularly described as follows:

MAKE/SERIES: FOTON/TORNADO 2.5;

BODY TYPE: CAB AND CHASIS;
ENGINE NO.: YZ4102ZLQB402002978;
CHASSIS NO.: LBVB8JE61EE002287;
MV FILE NO.: 9008-00000017898;
PLATE NO. : ;

6. Unfortunately, sometime in August 2023, the Certificate of

Registration (C.R.) of the above-described motor vehicle was misplaced, I then
tried and exerted efforts to locate said C.R. in every corner of places in our house
where I probably placed it, but to no avail and the same proved futile such that after
a reasonable time that elapsed, I now consider it lost for all intents and purposes;

7. This statement of loss is made in good faith and never intended to defraud
the Land Transportation Office (LTO) and third persons, and said Certificate of
Registration (C.R.) was never confiscated from me by said agency for violation of traffic
laws, rules and regulations but only due to the reason herein set forth;

8. I am executing this statement to attest the truth of all the foregoing and to
request for a new/duplicate copy of said Certificate of Registration (C.R.) and for other
legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 10th day of October

2023 at Catbalogan City.

EBEL E. OBOR
Affiant

SUBSCRIBED AND SWORN to before me this 10th day of October 2023 at

Catbalogan City.
 REPUBLIC OF THE PHILIPPINES)
PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFFIDAVIT OF LOSS

I, JOY SISON JAKOSALEM , of legal age, single, Filipino and with residence at Purok
1, Sitio Sto. Niño, San Andres, Catbalogan City, Samar, after having been duly sworn to in
accordance with law do hereby depose and state that:

1. That I am the present and lawful owner of a motor vehicle with Official Receipt
(O.R.) No. 730131684 issued on May 15, 2015 by the LTO, and Certificate of Registration
(C.R.) No. 217886841 issued on May 14, 2015 by the LTO and more particularly described as
follows:

MAKE/SERIES : HYUNDAI/EON 0.8 GLS MT;

TYPE OF BODY : SUB COMPACT;
ENGINE No. : G3HAEM314364;
CHASSIS NO. : MALA351AAFM350066;
MV FILE NO. : 9008-00000045201
PLATE NO. : AAW-5572;

2. That said motor vehicle is registered in the name of my late father SALVADOR
P. JAKOSALEM who died on 16 March 2020 at Tacloban City, but I am now the actual
possessor of the same;

3. That however, the PLATE NUMBER of said motor vehicle was dropped
somewhere and despite repeated efforts to locate it, the same proved futile, such that I
now consider the same lost for all intents and purposes;

4. This statement of loss is made in good faith and never intended to defraud the
Land Transportation Office (LTO) and third persons;

5. I am executing this statement to attest the truth of all the foregoing and to request
for replacement of plate number or authorization to use a temporary plate (number) with
the Land Transportation (LTO), Catbalogan City and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 17 th day of November

2021 at Catbalogan City.

JOY SISON JAKOSALEM

Affiant

SUBSCRIBED AND SWORN to before me this 17 th of November 2021 at

Catbalogan City, affiant exhibiting to me her PRC ID No. 0911604 valid until 10/28/22.
 REPUBLIC OF THE PHILIPPINES)
PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFFIDAVIT OF LOSS

I, PONCIA MARCHELL COMENDADOR-VALLES , of legal age, widow, Filipino

and with residence at Brgy. Lunang-1, Almagro, Samar, after having been duly sworn to in
accordance with law do hereby depose and state that:

1. That I am the present and lawful owner of a motor vehicle with Certificate of
Registration (C.R.) No. 000000021371542 issued by the LTO and more particularly described as
follows:

MAKE/SERIES : HONDA/CFT125MSE;
TYPE OF BODY : MOTORCYCLE;
ENGINE No. : KPY00E064620;
CHASSIS NO. : KPY00064690;
MV FILE NO. : 9008-00000040308;

2. That said motor vehicle is registered in the name of my late husband, ANSELMO
V. VALLES, but I am now the actual possessor of the same;

3. That however, on 20 July 2019, the CERTIFICATE OF REGISTRATION (C.

R.) of said motor vehicle, I believed it was misplaced or dropped somewhere at our house
and despite repeated efforts to locate it, the same proved futile, such that I now consider
the same lost for all intents and purposes;

4. This statement of loss is made in good faith and never intended to defraud the
Land Transportation Office (LTO) and third persons, and said Certificate of Registration
(C.R.) was never confiscated from me by said agency for violation of traffic laws, rules
and regulations but only due to the reason herein set forth; ;

5. I am executing this statement to attest the truth of all the foregoing and for
registration with the Land Transportation (LTO), Catbalogan City and for other legal
purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 22 nd day of November

2021 at Catbalogan City.

PONCIA MARCHELL COMENDADOR-VALLES

Affiant

SUBSCRIBED AND SWORN to before me this 22nd of November 2021 at

Catbalogan City, affiant exhibiting to me her UMID CRN-006-0128-1347-0.
 REPUBLIC OF THE PHILIPPINES)
PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFFIDAVIT OF LOSS

I, JOY SISON JAKOSALEM , of legal age, single, Filipino and with residence at Purok
1, Sitio Sto. Niño, San Andres, Catbalogan City, Samar, after having been duly sworn to in
accordance with law do hereby depose and state that:

1. That I am the present and lawful owner of a motor vehicle with Official Receipt
(O.R.) No. 730131684 issued on May 15, 2015 by the LTO, and Certificate of Registration
(C.R.) No. 217886841 issued on May 14, 2015 by the LTO and more particularly described as
follows:

MAKE/SERIES : HYUNDAI/EON 0.8 GLS MT;

TYPE OF BODY : SUB COMPACT;
ENGINE No. : G3HAEM314364;
CHASSIS NO. : MALA351AAFM350066;
MV FILE NO. : 9008-00000045201
PLATE NO. : AAW-5572;

2. That said motor vehicle is registered in the name of my late father SALVADOR
P. JAKOSALEM who died on 16 March 2020 at Tacloban City, but I am now the actual
possessor of the same;

3. That however, the PLATE NUMBER of said motor vehicle was dropped
somewhere and despite repeated efforts to locate it, the same proved futile, such that I
now consider the same lost for all intents and purposes;

4. This statement of loss is made in good faith and never intended to defraud the
Land Transportation Office (LTO) and third persons;

5. I am executing this statement to attest the truth of all the foregoing and to request
for replacement of plate number or authorization to use a temporary plate (number) with
the Land Transportation (LTO), Catbalogan City and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 17 th day of November

2021 at Catbalogan City.

JOY SISON JAKOSALEM

Affiant

SUBSCRIBED AND SWORN to before me this 17 th of November 2021 at

Catbalogan City, affiant exhibiting to me her PRC ID No. 0911604 valid until 10/28/22.
 REPUBLIC OF THE PHILIPPINES)
PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFFIDAVIT OF LOSS

I, IVAN ABROGAR PONTEJO, of legal age, married, Filipino and with residence
at Tarangnan, Samar, after having been duly sworn to in accordance with law do hereby
depose and state that:

1. That I am the present and lawful owner of a motor vehicle with Official Receipt
(O.R.) No. 1572577020 issued on June 29, 2020 by the LTO, Tacloban City, Leyte and more
particularly described as follows:

MAKE/SERIES : Mitsubishi/L300
TYPE OF BODY : Van;
ENGINE No. : 4D56A-L3910
CHASSIS NO. : PAEL039PYYB027947
PLATE NO. : HVT984;

2. That said motor vehicle is registered in the name of JUANITA L.

ECHEVARRIA, but I am now the actual possessor of the same;

3. That however, the Certificate of Registration (C.R.) of said motor vehicle was
misplaced and lost in the residence of the former owner and despite repeated efforts to
locate it, the same proved futile, such that I now consider the same lost for all intents and
purposes;

4. This statement of loss is made in good faith and never intended to defraud the
Land Transportation Office (LTO) and third persons, and said Certificate of Registration
(C.R.) was never confiscated from me by said agency for violation of traffic laws, rules
and regulations but only due to the reason herein set forth;

5. I am executing this statement to attest the truth of all the foregoing and for
registration with the Land Transportation (LTO), Catbalogan City and for other legal
purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 22 nd day of June 2021

at Catbalogan City.

IVAN ABROGAR PONTEJO

Affiant

SUBSCRIBED AND SWORN to before me this 22 nd day of June 2021 at Catbalogan

City, affiant exhibiting to me his with COMELEC VIN 6020-0062A-E0787IAP10000.
 REPUBLIC OF THE PHILIPPINES)
PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFIDAVIT OF LOSS

I, MICHAEL D. REAL, of legal age, married, Filipino and with residence at P-7,
Brgy. Silanga, Catbalogan City, after having been duly sworn to in accordance with law
do hereby depose and state that:

9. I am the present and lawful owner of a motor vehicle particularly, described as

follows:

MAKE/SERIES: HONDA CFT125MREII;

BODY TYPE: MOTORCYCLE;
ENGINE NO.: KPY20E055241;
CHASSIS NO.: KPY20055265;
MV FILE NO.: 0801-00000092538;
PLATE NO. : 080105;

10. However, on 08 November 2020, said motorcycle was robbed by an unknown

individual; the culprit went through the Ubox of said motorcycle maybe thinking that it
contains money leaving the same empty, thus, the Certificate of Registration (C.R.) and
Official Receipt (O.R.) which were contained thereat were already gone and missing when
I luckily found my motorcycle; despite repeated efforts to locate it, the same proved futile,
such that I now consider it lost for all intents and purposes;

11. This statement of loss is made in good faith and never intended to defraud the
Land Transportation Office (LTO) and third persons, and said Certificate of Registration
(C.R.) and Official Receipt (O.R.) were never confiscated from me by said agency for
violation of traffic laws, rules and regulations but only due to the reason herein set forth;

12. I am executing this statement to attest the truth of all the foregoing and to request
for a new/duplicate copy of said Certificate of Registration (C.R.) and Official Receipt
(O.R.) and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 11th day of October

2020 at Catbalogan City.

MICHAEL D. REAL
Affiant

SUBSCRIBED AND SWORN to before me this 11 th day of November 2020 at

Catbalogan City, affiant exhibiting to me his AFP ID No. A20-E-231562 valid until 10
January 2022.

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)
 AFIDAVIT OF LOSS

I, LEONIDES PABUA FROILAN, of legal age, married, Filipino and with

residence at P-7, Brgy. Canlapwas, Catbalogan City, after having been duly sworn to in
accordance with law do hereby depose and state that:

13. I am the present and lawful owner of a motor vehicle particularly,

described as follows:

MAKE/SERIES: TOYOTA TAMARAW;

BODY TYPE: UTILITY VEHICLE;
ENGINE NO.: 1526175;
CHASSIS NO.: CF50-0037332;
MV FILE NO.: 13120000055660A;
PLATE NO. : SEU918;

14. However, sometime in August 2020, the Certificate of Registration (C.R.) of said
motor vehicle was misplaced at the Land Transportation Office (LTO), Catbalogan City,
and despite repeated efforts to locate it, the same proved futile, such that after the lapse of
reasonable time, I now consider it lost for all intents and purposes;

15. This statement of loss is made in good faith and never intended to defraud the
Land Transportation Office (LTO) and third persons, and said Certificate of Registration
(C.R.) was never confiscated from me by said agency for violation of traffic laws, rules
and regulations but only due to the reason herein set forth;

16. I am executing this statement to attest the truth of all the foregoing and to request
for a new/duplicate copy of said Certificate of Registration (C.R.) in support of my petition
for the change of said motor vehicle ownership and for other legal purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 8th day of September

2020 at Catbalogan City.

LEONIDES PABUA FROILAN

Affiant

SUBSCRIBED AND SWORN to before me this 8 th day of September 2020 at

Catbalogan City, affiant exhibiting to me his LTO Professional Driver’s License No. HO1-
83-001544 valid until 23 July 2022.

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFIDAVIT OF LOSS

I, ALEJANDRO BABALCON SABARRE JR., of legal age, married, Filipino

and with residence at Brgy. Ubanon, Paranas, Samar, after having been duly sworn to in
accordance with law do hereby depose and state that:

17. I am the lawful owner of a motorcycle particularly, described as

follows:
 MAKE/SERIES: TOYOTA HILUX 2.5LG4X;
BODY TYPE: PICK-UP;
ENGINE NO.: 2KDA506779;
CHASSIS NO.: MRDER39G507630675;
MV FILE NO.: 1301-00000167672;
PLATE NO. : AAX-4545;

18. However, sometime in May 2020, the Certificate of Registration (C.R.) of said
motor vehicle was misplaced at the Asia United Bank (AUB), Catbalogan City, and despite
my repeated efforts to locate it, the same proved futile, such that after the lapse of
reasonable time, I consider it lost for all intents and purposes;

19. This statement is made in good faith and never intended to defraud the AUB and
third persons, and said Certificate of Registration (C.R.) was never confiscated from me by
the LTO for violation of traffic laws, rules and regulations but only due to the reason
herein set forth;

20. I am executing this statement to attest the truth of all the foregoing and to request
for a new/duplicate copy of said Certificate of Registration (C.R.) in support of my petition
for the renewal of its chattel mortgage with the AUB, Catbalogan City, and for other legal
purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 21 st day of July 2020 at

Catbalogan City.

ALEJANDRO BABALCON SABARRE JR.

Affiant

SUBSCRIBED AND SWORN to before me this 21 st day of July 2020 at Catbalogan

City, affiant exhibiting to me his LTO Professional Driver’s License No. HO1-92-008061
valid until 2024/05/11.

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SAMAR…..……….) SS
CITY OF CATBALOGAN………….)

AFIDAVIT OF LOSS
 I, JAKE D. ANDRINO, of legal age, single, Filipino and with residence at
Poblacion Zone II, Capoocan Leyte, after having been duly sworn to in accordance with
law do hereby depose and state that:

21. I am the lawful owner of a motorcycle particularly, described as

follows:

MAKE/SERIES: HONDA/CBF110MSB;
BODY TYPE: MOTORCYCLE;
ENGINE NO.: KWS00006357;
CHASSIS NO.: KWS00006357;
FILE NO.: 0820-00000030195;
PLATE NO. : 9052HH;

22. I lawfully acquired said motorcycle from its former owner, MOTALIB B.
BUISAN, of legal age, single, Filipino and a resident Purok 26, Barangay 76-A, Bucana,
Davao City, on 07 February 2020, a copy of the Deed of Absolute Sale is hereto attached;

23. However, the tin plate of said motorcycle was lost as it might dropped from its
rear side without my knowledge and that despite my repeated efforts to locate it, the same
proved futile, such that after the lapse of reasonable time, I consider it lost for all intents
and purposes;

24. This statement is made in good faith and never intended to defraud the
government and third persons, and said tin plate was never confiscated from me by the
LTO for violation of traffic laws, rules and regulations but only due to the reason herein set
forth;

25. I am executing this statement to attest the truth of all the foregoing and to request
for a new tin plate for my motorcycle with the Land Transportation Office, Catbalogan
City, in lieu of the one lost and for renewal of registration purposes.

IN WITNESS WHEREOF, I hereunto affix my signature this 7 th day of February

2020 at Catbalogan City.

JAKE D. ANDRINO
Affiant

SUBSCRIBED AND SWORN to before me this 27th day of August 2019 at

Catbalogan City, affiant exhibiting to me his LTO Professional DL #H12-19-001670 valid
until 2024/04/26,
 AFFIDAVIT OF CONSENT

That I, CANDICE MARIE G. DELMONTE, of legal age, single, Filipino and a

resident of Brgy. Lipata, Paranas, Samar, after having been duly sworn to in accordance
with law do hereby depose and state: that-

1. I am the registered owner of a parcel of land located at

Brgy. Lipata, Paranas, Samar;

2. As such, I affirm and confirm my consent and authority

previously vested in the registered passenger motor vehicle LOURDES C.
DELMONTE, of legal age and a resident also of our barangay, to
continuously devote a portion of my aforesaid parcel of land to be used
as she continuously uses as her vehicles’ garage;

3. The herein authority so vested upon said person/operator is

thru my liberality and kindness and not for unlawful considerations;

4. I am executing this statement to attest the truth of all the

foregoing and for legal purposes.

IN WITNESS WHEREOF, I have hereunto set my signature at Catbalogan City,

Samar, on this 24th day of January 2017.

CANDICE MARIE G. DELMONTE

Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this 24 th day of January 2017 at

Catbalogan City, Samar, affiant CANDICE MARIE G. DELMONTE exhibiting to me
her BIR TIN ID No. 263-367-921.

Aff/loss orcr
 ,

WITNESS MY HAND AND SEAL.

I, JENNIFER B. LUCIDO, of legal age, married, Filipino and with residence

at Poblacion 6, Paranas, Samar, after having been duly sworn to in accordance with law
do hereby depose and state that:

1. I am a holder of a driver’s license issued by the Land

Transportation Office (LTO), Catbalogan City;

26. Unfortunately, however, on the morning of 9 January

2017, I discovered that my wallet containing said driver’s license and a
little money slipped out of my pant’s back pocket while I was in
Tacloban City attending a personal endeavor, and I discovered such loss
only when I was already at home;

27. I then exerted earnest efforts to look for said driver’s

license but the same proved futile, such that after the lapse of reasonable
time, I consider it lost for all intents and purposes;

28. This statement is made in good faith and never intended to

defraud the government and third persons, and said driver’s license was
never confiscated from me by the LTO for violation of traffic laws, rules
and regulations but only due to the reason herein set forth;

29. I am executing this statement to attest the truth of all the

foregoing and to facilitate the issuance of a new driver’s license with the
Land Transportation Office, Catbalogan City, in lieu of the one lost.

IN WITNESS WHEREOF, I hereunto affix my signature this 19th day of January

2017 at Catbalogan City.

JENNIFER B. LUCIDO
Affiant

SUBSCRIBED AND SWORN to before me this 19th day of January 2017 at

Catbalogan City, affiant exhibiting to me her PRC ID No. 0009616 valid until January 7,
2018.
REPUBLIC OF THE PHILIPPINES)
PROVINCE OF SAMAR…………..) SS
CITY OF CATBALOGAN………….)

AFFIDAVIT OF LOSS

I, ROGELIO L. TINAY, , of legal age, married, Filipino and with residence at

Brgy. Bagacay, Hinabangan, Samar, after having been duly sworn to in accordance with
law do hereby depose and state that:

1. My late father Victor L. Tinay, a former mayor of Hinabangan, Samar,

was alleged to be a possessor of a Taurus firearm, described as Cal. 9mm with serial no.
TRF 26095;

2. However, after his death on 07 October 2014 in Brgy. Bagacay,

Hinabangan, Samar, it was unfortunate that said firearm, if there was any, could no
longer be found despite repeated and exhaustive search and lapse of sufficient period of
time; and this holds true as I and his heirs collated and inventoried all his personal papers
and documents, personal properties existing and saw none said firearm, among others;

3. While I could not personally confirm of the existence of said firearm, I do

still affirm, under pain of perjury, that said firearm is not in our possession, and which
reason I consider the same lost for all intents and purposes;

4. This statement is made in good faith and not intended to violate firearm
laws, rules and regulations but solely due to the valid reasons herein set forth;

5. I am executing this statement to attest the truth of all the foregoing and
for legal purposes:

IN WITNESS WHEREOF, I hereunto affix my signature this 22 nd day of March

2016 at Catbalogan City.

ROGELIO L. TINAY
Affiant

SUBSCRIBED AND SWORN to before me this 22 nd day of March 2016 at

Catbalogan City, affiant exhibiting to me his UMID ID CRN 0111-2932758-2.