REPUBLIC OF THE PHILIPPINES}

CAMILING, TARLAC} S.S.

AFFIDAVIT OF LOSS

I, CLARITA PARAGAS TACDOL, 75 years old, Filipino Citizen,

widow and a resident of PAO 3rd, Camiling, Tarlac, Philippines, after having
been sworn in to in accordance with law, hereby depose and state THAT:

1. I am an owner of a parcel of land located at Barangay PAO 3 rd,

Camiling, Tarlac covered by Transfer Certificate of Title (TCT)
No.149516 registered in my name;

2. I have been keeping the Second Owner’s Duplicate Copy inside

one of the drawers in my room for safekeeping;

3. On December 2017 I went to the one-stop shop office of Camiling,

located within the Camiling Municipal Compound to pay my taxes
and brought with me the Transfer Certificate of Title No.149516;

4. When I arrived home, I noticed that my Second Owner’s Copy of

the Transfer Certificate of Title No.149516 was missing and only
the receipt of the payment of taxes I paid was with me;

5. I immediately called my daughter and we tried to find the said

missing title in our house before going to one-stop shop office;

6. When we arrived at the one-stop office of Camiling, I asked the

persons inside and the officers therein, if they have seen a transfer
certificate of title but they all told me that they did not; nonetheless
the officers of the said office told me to return the following day
and they will try to find the same;

7. As advised by the officers of the said office, I went back the

following morning and they told me that they did not find my
missing title, thus, despite diligent efforts made, I consider the
same as lost and beyond recovery;

8. I am executing this Affidavit to inform the Registry of Deeds for

the Province of Tarlac and Land Registration Authority concerning
the loss of the original copy of Owner’s Duplicate Certificate of
Transfer Certificate of Title (TCT) No. 149516 registered in my
name; and to request the said authorities to annotate this Affidavit
in the file copy of the said certificate with the Registry of Deeds;

9. Finally, I am executing this Affidavit to attest to the foregoing

statements and for all legal intents and purposes it may serve.
 IN WITNESS WHEREOF, I have hereunto affixed my signature this
July 12, 2018 at Camiling, Tarlac, Philippines.

CLARITA PARAGAS TACDOL

Affiant

SUBSCRIBED AND SWORN to before me on the date and place

indicated above. Affiant exhibited to me her Senior Citizen’s ID with No.
6102 issued on October 5, 2015 by the Office for Senior Citizen’s Affairs,
Camiling, Tarlac.