REPUBLIC OF THE PHILIPPINES)

Legazpi City ) ss.

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

Affidavit of Loss
I, MARIA CRISTINA ARMEÑA MARTINEZ, Filipino, of legal age, married and a resident of 288-1 DBP
Comp., Lakandula Drive Cruzada Legazpi City Philippines , after having duly sworn in accordance with the law, hereby
depose and say;

1. That I am the wife of FELICISIMO E. MARTINEZ the registered owner of Lot No. 140
situated in BARRIO OF NAGAO, OAS, ALBAY containing an area of THIRTY TWO
THOUSAND and SIX (32, 006) SQUARE METERS covered by TRANSFER
CERTIFICATE OF TITLE (TCT) NO. T-95540;

2. That we were issued by the Land Registration Authority of an OWNERS DUP LICATE
COPY of Transfer CERTIFICATE OF TITLE NO. T-95540;

3. That I was entrusted by my husband to safe keep the title of the said land while he is
working abroad;

4. That sometime on January 2015 my husband ordered me to search the title of the above
mention property in my record files;

5. That I conducted a thorough search in my record files however the said title can no
longer to be found;

6. That despite diligent search and effort of the OWNERS DUPLICATE COPY of
TRANSFER CERTIFICATE OF TITLE NO. T-95540 it can no longer be found and it is
considered lost for all legal purposes; and

7. That I am executing this Affidavit of Loss to attest the truth of the foregoing statements
and for the purpose of complying with the requirements for the FILING OF ISSUANCE
OF THE 2 n d OWNER’S COPY and for whatever legal intent and purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____________ in the

________________________, Philippines.

MARIA CRISTINA ARMEÑA MARTINEZ

Affiant
VIN NO: 0506-0177B-A0365MAM20000

SUBSCRIBED AND SWORN TO before me this ________________________ a t

________________________. Affiant personally appeared. Affiant further exhibited to me to
his/her competent proof of identity through the document written below his/her name, pursuant
to Rule 2, Sec. 12 (a) of the 2004 Rules on Notarial Practice.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2016.