REPUBLIC OF THE PHILIPPINES

QUEZON CITY, METRO MANILA )

)
S.S.

AFFIDAVIT OF LOSS
I, Nimfa E. Violanda, Filipino of legal age, single, with residence and
postal address at 5th Avenue, Barangay Socorro Wood Townhomes 156-unit 211
after having been duly sworn to in accordance with law, do hereby depose and
state:
1.

That the following documents are no longer in my possession:

a) Affidavit of Loss notarized by Atty. Dame Plando
b) Certification from Ecing Sy
c) Certification from Branch II PAO
d) Sketch Plan from Benjamin Violanda
e) Some xerox copy of documents
2.

That the above-mentioned documents was misplaced somewhere

in our house and despite diligent and exhausted effort I exerted to
locate, the same could no longer be found, for this reason, I am
declaring and considering said documents as lost and beyond
recovery;
3.

That I have executed this affidavit to attest to the truthfulness

and veracity of all foregoing fact and for whatever legal intent this
may serve, especially for the information of all the authorities
concern of such loss.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my

signature this 29th day of July, 2013 in Quezon City, Metro Manila.

Nimfa E. Violanda
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME this 29th day of July, 2o13
at Quezon City, Metro Manila. Affiant exhibited to me her Voters Identification
Card No. 3906-3118C-K266ONEV20002-4 issued by the COMELEC.

Doc. No. _____;

Book No. _____;
Page No. _____;
Series of 2013