Republic of the Philippines )

Province of Isabela ) S.S.

x------------------------------------x

AFFIDAVIT OF LOSS

I, DOMINGO T. ABAD, of legal age, Filipino, married and a resident of Purok 4,

Barangay Balug, Tumaini, Isabela, after having been duly sworn to in accordance with law,
depose and state THAT:

1. I was in possession of the copy of RELEASE OF CHATTEL MORTGAGE issued

by Philippine Savings Bank;

2. I acquire the said document along with the original copy of Certificate of Registration
and the copy of Promissory Note with Chattel Mortgage from Ms. Salvacion S.
Gomez through Deed of Sale of Motor Vehicle last October 2023;

3. It so happened, however, said Release of Chattel Mortgage was lost and nowhere to
be found;

4. Earnest efforts were exerted on my part to retrieve the same but to no avail;

5. I declare under penalties of perjury that this affidavit has been made in good faith
verified by me and to the best knowledge and belief is true and correct;

6. This affidavit is being executed to show proof that the vehicle has been fully paid and
to update ownership records with the concerned Registry of Deeds and for all
subsequent purposes necessary for its updates;

7. Likewise, it is executed to attest to the veracity of the foregoing instrument in order to

establish the existence of the above-mentioned RELEASE OF CHATTEL
MORTGAGE for purposes not contrary to law, morals, good custom and public
policy.

IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of February
2024, in the Municipality of Tumauini, Province of Isabela, Philippines.

DOMINGO T. ABAD
(Signature of Affiant)

SUBSCRIBED AND SWORN TO before me this 13th day of February 2024 in

Tumauini, Isabela, affiant exhibiting to me his Driver’s License with No. B02-93-032926
expiring on May 7, 2032 at Tumauini, Isabela.
Doc. No. ____
Page No. ____
Book No. ____
Series of 2024.