REPUBLIC OF THE PHILIPPINES )

MAKATI CITY ) S. s.

AFFIDAVIT OF LOSS

I, EARVIN JAMES M. ATIENZA, Filipino, of legal age, single and with address
at 2057 Anonas St., Brgy. 628, Santa Mesa, Manila 1016 NCR, after having duly sworn
to in accordance with law, hereby depose and say that:

1. I am one of the grandchildren of the late spouses Ernesto C. Atienza, Sr.

and Basilisa G. Naguit-Atienza;

2. On May 29, 2014, an owner’s duplicate of Transfer Certificate of Title

(TCT) No. 064-2014003614 was issued in the names of my late grandparents to cover
their property described as Lot 811-F-39-A located in Barangay Malitbog, Bongabong
Oriental Mindoro with an area of Nine Hundred and Twenty Six (926) square meters,
more or less;

3. The custody of the said Owner’s Duplicate TCT was left in the possession
of my father, Edgar Francisco N. Atienza, until his untimely demise last June 12, 2020;

4. In the process of settling their estates, I discovered that the said Owner’s
Duplicate TCT could no longer be found in the usual place where my father kept
important documents, nor was it in the possession of my uncle and auntie who were
the surviving legitimate children of my grandparents;

5. Despite diligent efforts to trace and locate the aforementioned Owner’s

Duplicate TCT, the same proved to be futile;

6. I am executing this affidavit to attest to the truth of the foregoing

statements for the purpose of reporting the loss of the Owner’s Duplicate TCT No. 064-
2014003614 issued by the Registry of Deeds for the Province of Oriental Mindoro, and
for whatever purpose this may legally serve.

FURTHER AFFIANT SAYETH NAUGHT.

EARVIN JAMES M. ATIENZA

Affiant

SUBSCRIBED AND SWORN to before me on this __________________,

affiant exhibiting to me his Non-professional Driver’s License No. N01-11-008066 issued
by the Land Transportation Office.

JOSE V. MEJIA
Notarial Commission No. M-366, Makati City
Until 31 December 2021
Roll of Attorneys No. 34397
Doc. No. __;
IBP No. 665910, Lifetime, Pampanga
Page No. __;
PTR No. 8126077, 7-JAN-20, Makati City
Book No. __;
MCLE Exemption no. VI-000196
Series of 2020. Reissued on 15-AUG-2019
Valid until 14-APR-2022