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Affidavit of Loss Title

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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF ISABELA )S.S


MUNICIPALITY OF ECHAGUE)

AFFIDAVIT OF LOSS

I, CRISPINA VALDEZA, of legal age, Filipino, married and a resident of Brgy.


Taniguing, Echague, Isabela, after being sworn in accordance with law, hereby depose and state
THAT:

1. I was a beneficiary of the Comprehensive Agrarian Reform Law Program by the


government. I was issued a Transfer Certificate of Title No. CLOA-28276 over the parcel of land
that I am cultivating;

(Copy of the Tranfer Certificate of Title No. CLOA-28276 is hereto attached and marked
as Annex “A”)

2. The said Title was under the custody of my father Dayo A. Valdeza since it was issued
to me. He kept it in their house located at Brgy. Taniguing, Echague,Isabela;

3. In the first week of April 2019, the house of my parents was transferred to an adjacent
lot. My father made a general cleaning and left those things which are no longer necessary and
burned them when he transferred. When I asked my father about my Title, he search for it but it
was never found. I believe that it was burned when he made the general cleaning. All diligent
efforts I and my father exerted to locate and retrieve it were in vain; hence for all legal intents
and purposes it is now deemed lost and beyond recovery;

4. I certify and confirm that the parcel of land covered by Transfer Certificate of Title No.
CLOA-28276 of the Registry of Deeds of Isabela was never mortgaged, sold, conveyed, disposed of, or
encumbered, to any other person or entity. I certify and confirm further that said document was
neither confiscated nor relinquished in favor of, any government entity agency, or authority;

6. I attest to the truth of the foregoing statements to the best of my own personal knowledge and based
on authentic documents or records. I am executing this Affidavit of Loss to support my application for a new
owner’s duplicate copy of Transfer Certificate of Title No. CLOA-28276 as well as for all lawful
intents and purposes it may serve.

IN WITNESS WHEREOF, I set my hand this 30th day of April 2019 at Echague,
Isabela, Philippines.

CRISPINA A. VALDEZA
Affiant

SUBSCRIBED AND SWORN to before me this 30th day of April, 2019 at Echague,
Isabela. Affiant has exhibited to me her Identification Card- COMELEC with VIN: 3112-0080A-
H1679CBV1000 bearing her picture and signature as competent proof of her identity.

Doc No. ______


Page No. _____
Book No. _____
Series of 2019

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