REPUBLIC OF THE PHILIPPINES | S. S.

DONE: IN THE CITY OF DAVAO |

AFFIDAVIT OF LOSS

I, DODONG S. TUKIB, of legal age, single, Filipino, and a resident of Prk 32, Panacan, Davao City,
Philippines, after being sworn in accordance with law, hereby depose and state—

1. I am the purchaser / vendee of that parcel of land located at Barangay Panacan, Davao City
containing an area of Three Hundred Square Meters covered by Transfer Certificate of Title No. T-69715 of the
Registry of Deeds of Davao City—as evidenced by the Deed of Sale of a Registered Land which was executed in
my favor by Marvin M. Mercedez and thereupon acknowledged before Notary Public John Putol and docketed in
his Notarial Registry as “Doc. No. 542; Page No. 91; Book No. 11; and Series of 2015.” A copy of the said Deed
of Sale of a Registered Land is hereto attached and made an integral part hereof as ANNEX A.

2. Immediately after the Deed of Sale of a Registered Land was executed, the original duplicate
owner’s copy of Transfer Certificate of Title No. T-69715 was turned over to me by Marvin M. Mercedez. He
likewise delivered to me possession the subject parcel of land and since then I have openly exercised and
maintained all rights of ownership thereon.

3. I was not able to immediately effect transfer the title in my name because I was then preoccupied
with my studies at Central Mindanao University in Musuan, Bukidnon. Sometime in April 2016, when I decided
to process the transfer of the title in my name, because I finally had the time and opportunity to do so, I
discovered that the original duplicate owner’s copy of Transfer Certificate of Title No. T-69715 was missing. I
could no longer find it in my files. All diligent efforts I 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. T-69715
of the Registry of Deeds of Davao City 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.

5. 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. T-69715 as well as for all lawful intents and
purposes it may serve.

IN WITNESS WHEREOF, I set my hand this 4th day of October 2019 at Davao City, Philippines.

DODONG S. TUKIB
Affiant
Driver’s License No. K02-02-054831
Firearm License No. 845133/1388258

SUBSCRIBED AND SWORN to before me this 4th day of October 2019 at Davao City, Philippines.

ATTY. OSCAR A. CORPUZ, JR. Notary Public Until December 31, 2013 N. A. No. 54-NC-12-R
Attorney’s Roll No. 53486 IBP No. 863438 01.02.2012 Baguio City PTR No. 0793799 01.02.2012 Baguio City
MCLE Compliance No. IV-0000200; 08.04.2010 Doc. No. 189 Page No. 38 Book No. III Series of 2012

ATTY. SANDY L. EDRALIN

Notary Public
Until December 31, 2022
N. A. No. 31-NC-12-R
Doc. No. 111 Attorney’s Roll No. 96969
Page No. 38 IBP No. 201233 01.02.2015 Davao City
Book No. III PTR No. 1234567 01.02.2015 Davao City
Series of 2019 MCLE Compliance No. XI-0000100; 08.04.2015