REPUBLIC OF THE PHILIPPINES)

PARANAQUE CITY )S.S.

AFFIDAVIT OF LOSS

We, SPS. DENNIS FORTEO FURIO and DONNABEL ROLLUQUI FURIO, both of
legal age, Filipinos, and residents of Azure Urban ResKM 16 West Service Rd., Bicutan, Parañaque
City, after having been sworn to in accordance with law, hereby depose and say that;

1. That we are the owners/holders of the original copy of Official Receipt/Sales Invoice issued
to us by Registry of Deeds in Parañaque City;

2. That sometime on December 1, 2022 when we’ve noticed that said OR/Sales Invoice was
misplaced somewhere and we considered it lost;

3. That effort to locate said OR/Sales Invoice but despite diligent search it could no longer be
found and same is beyond recovery;

4. That we are executing this affidavit to attest to the truth of the foregoing facts and
whatsoever this may serve

IN WITNESS WHEREOF, we have hereunto set our hands this 10 th day of March 2023, in the
City of Paranaque, Philippines.

DENNIS FORTEO FURIO DONNABEL ROLLUQUI FURIO

Affiant Affiant
Driver’s License No. N01-15-024592 Driver’s License No. N01-15-024740

SUBSCRIBED AND SWORN to before me, in the City of Paranaque, this 10 th day of
March 2023.

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