Republic of the Philippines}

Ormoc City
} S.S
AFFIDAVIT OF LOSS
I, VIOLETA MENDOZA DIENER, of legal age, Dual Citizen, widow, and a
resident of Frankfurt, West Germany, after having been sworn in accordance
with the law, hereby depose and say:
1.

That I am the registered owner of land known as Lot 7790-E of the

subdivision plan, Psd 083738-007316-D, being a portion of Lot
7790 of Ormoc Cadastre located at Brgy. Dayhagan, Ormoc City
and covered by Transfer Certificate of Title No. 26570 issued by
the Office of Registry of Deeds of Ormoc City containing an area of
ONE HUNDRED NINETY EIGHT (198) SQUARE METERS, more or
less;
2.

That the Owners Original Copy of said title has been lost during
the onslaught of
super typhoon Yolanda on November 8, 2013 ;

3.

That said Title was not lend to another person or entity as

security for any obligation nor any of our representative; and

4.

That I am executing this affidavit in order to attest to the truth

of the foregoing and for any legal purpose this affidavit may serve.

IN WITNESS WHEREOF, I set my hand this _______________, at Frankfurt,

west Germany.
VIOLETA MENDOZA DIENER
Affiant
ID NO.__________________
SUBSCRIBED AND SWORN to before me _____________, in Frankfurt,
West Germany.