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Province of Nueva Vizcaya) S.s.

Bayombong, Nueva Vizcaya)

AFFIDAVIT OF LOSS

I, DIANA JEAN S. LITONJUA, of legal age, married, Filipino


citizen, and a resident of Purok 2, Bonfal Proper, Bayombong, Nueva
Vizcaya, after being sworn in accordance with law, hereby depose and
state:

1. That I am the daughter of Ruby Afan De Leon who temporarily


resides at #4447, Pitch Pine, San Jose, California, USA;

2. That sometime in August 78, 2014, my mother brought a certain


parcel of land, located at Bonfal Proper, Bayombong, Nueva
Vizcaya, covered by Certificate of Title No. P-1340 from the
surviving heirs of Nicolas Galicia, the registered owner of the
land;

3. That the land title was entrusted to me by my mother, and along


with my other important documents. I placed the title inside a
cabinet in our house;

4. That on November 3, 2014 at around 11:00 o’clock in the


evening, which I and my children were away, our house was
ransacked by unknown assailants and among the items that were
created among the items that were carted among, was the
Owner’s duplicate Copy of Certificate of Title No. P-1340;

5. That I repeated the incident to the Bayombong Police Station


but until now the perpetuators have not yet been identified. A
copy of the Police Blotter is hereto attached is hereto attached
and made an integral part hereof;

6. That I attest to the veracity of the foregoing statements.

IN WITNESS whereof, I have hereunto set my hand on this


Affidavit of Loss this 3rd day of March 2017 at Bayombong, Nueva
Vizcaya.

DIANA JEAN S. LITONJUA


Affiant
SUBSCRIBED AND SWORN TO before me this 3rd day of
March 2017 at Bayombong, Nueva Vizcaya, affiant having exhibited
to me her competent evidence of identity bearing her name and
signature.

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