Republic of the Philippines )

City of Tarlac )

AFFIDAVIT OF LOSS

I, Mah Hu Say, of legal age, its complicated, and a resident of Matalahib,

Tarlac City, after being duly sworn according to law, do hereby depose and state
that:

1. I am the registered owner of a parcel of land with the Transfer

Certificate Title No. 369184 or more particularly described as
follows: "A parcel of land ( Pot 10, block 23, of the cons.
Subdivision Plan Psd-0x-00xx55, being a portion of lot 18?6-B &
1836-C, Psd-03-094653,L.R.C. rec. No.), situated in the Barrio of
Matalahib, Mun.of Tarlac. Prov. Of Tarlac.***containing an area
of FIFTY TWO POINT FIFTY (52.50) square meters, more or less,
with improvements thereon;

2. I have donated the said parcel of land to my daughter Matty Wah Say;

3. Sometime on September 2016, the original copy of the said Deed of

Donation could not be found;

4. Despite diligent search and best efforts, I failed and, to this day, still fail to
locate and recover the said Deed of Donation such that I now believe that the
said Deed of Donation is lost beyond recovery;

5. Wherefore, I am executing this Affidavit of Loss to attest to the truth of the

foregoing and for whatever legal purposes that this may serve;

WITNESS WHEREOF, I have hereunto affixed my signature this 04th day

of January 2017 at Tarlac City, Philippines.

_____________________________
Mah Hu Say

SUBSCRIBED AND SWORN TO before me, a notary public in and for Tarlac
City this 04th day of January. The affiant, whom I identified through the following
competent evidence of identity: PASSPORT NO. EBDBRKADS7, issued by PE DOHA,
personally signed the foregoing instrument before me and vowed under penalty of
law to the whole truth of the contents of said instrument.

Doc. No. __________

Page No. __________
Book No. __________
Series of 2016.