Republic of the Philippines)

Las Pias City

)

AFFIDAVIT OF LOSS TITLE

I, , of legal age, widow, Filipino and resident of No., after being duly sworn
in accordance with law, hereby depose and say that:

1. I am the surviving legal wife of the deceased, registered owner

of a certain real property situated, covered by Transfer Certificate of Title
Noby the Registry of Deeds for
2. The said duplicate original owners copy of said Transfer Certificate of
Title was lost/ missing from my files.
3. The real property embodied under said certificate of title has not been
encumbered, mortgaged, pledged, sold, donated or otherwise alienated, nor the
subject of any power or authority granted to anyone.
4. In spite of all diligent efforts to look for said duplicate original owners
copy of said Transfer Certificate of Title, all my efforts proved futile and in vain,
thus I am declaring it loss.
5. Any transactions that will occur concerning my aforesaid real property
without my presence and approval are considered not valid.
6. I am executing this affidavit to attest to the truth of all the foregoing
facts, documents and the contents thereof for all its legal effects, intents,
consequences and purposes, including to request the Office of the Registry of
Deeds of the Las Pinas City to annotate this affidavit and for proper action,
pending my petition with the court for the issuance of another duplicate original
of said title certificate in lieu of the one that was lost.

Affiant
SUBSCRIBED AND SWORN to before me at Las Pias City this
______________2014,
affiant with identifications card consisting of:
_____________________.
Doc. No. _____
Page No. _____
Book No. _____
Series of 2014.