Republic of the Philippines)

Tarlac City . . . . . . . . . . . . . .)

AFFIDAVIT OF LOSS

I, NARDITO D. CALMA, of legal age, Filipino citizen and resident of Brgy.

San Rafael, Tarlac City, after having been duly sworn to in accordance with the law,
hereby depose and state THAT:
1. I am the father of Mary Ann Calma;
2. Mary Ann Calma is the registered owner of a parcel of land located at Brgy.
Binauganan, Tarlac City which is covered and described under Transfer Certificate of
Title No. 386707;
3. After the issuance of the said title, my daughter gave me the original title owner’s
duplicate copy for safekeeping before she left for the United States of America;
4. I then kept the original owner’s duplicate copy of the said title in a cabinet inside our
house where I also keep other important documents of mine;
5. Recently, my daughter called me and asked about the original owner’s duplicate copy
of the said title. It was then that I found out that I found out that it is missing;
6. I exerted diligent efforts to locate and recover the same, extending my search to the
premises of our house, but to no avail;
7. I am therefore treating the original owner’s duplicate copy of Transfer Certificate of
Title No. 386707 as lost for all legal intents and purposes;
8. I am executing this affidavit to attest to the truth of the foregoing statements and for
all legal intents and purposes it may well serve.

IN WITNESS HEREOF, I have hereunto set my hand this_____ day of March

2018in Tarlac City.

NARDITO D. CALMA
Affiant

SUBSCRIBED AND SWORN to before me this ___ of March 2018 at Tarlac City.
Affiant, whom I identified through his Driver’s License ID No.C11-70-009720 bearing
his photograph and signature, signed this document in my presence and avowed under
penalty of law to the whole truth of contents of the foregoing document.

Doc. No.: ______;

Page No.: ______;
Book No.: ______;
Series of 2018.