REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BATANGAS ) S. S.
TANAUAN CITY )

AFFIDAVIT OF LOSS

I, MARICRIS C. TERRADO, 22 years old, single, residing in Blk 10 Lot 8

Kassel Vista, San Pedro 1, Malvar, Batangas, after having been duly sworn to in
accordance with law, do hereby depose and say, THAT:

1. My family was able to purchase a house and lot located at Blk. 10 Lot 8
Kassel Vista, San Pedro 1, Malvar, Batangas.

2. The same was registered and named to my cousin, Ms. Rucelle

Calinisan.

3. We moved in the said house last 2018 and because we constructed a

fence within the perimeter of our house owned by my cousin, we were required to
obtain and pay a construction bond in the amount of three Thousand Pesos
(P3,000) with Tiera Alegre Realty Development Inc., the latter hence issued to us,
Official Receipt (OR) of the said Construction bond.

4. I was the one tasked to safe keep the said OR and I kept the same and
inserted the same in my personal notebook for easy access and convenience.

5. Presently, I was asked by my cousin of the said OR representing the

construction bond with the intention to refund the said amount, however, I looked
for the notebook where I inserted the said OR and have discovered the said OR
was no longer inserted therein and must have been taken, fell off or misplaced.

4. I exerted all diligent efforts to locate and retrieve the said OR to places it
might have been placed and even asked the households to its whereabouts but
the same remains futile.

5. Hence, I am now certain that the said OR representing the Construction

Bond is beyond recovery and due to the above circumstance, it is now considered
lost;

6. I am executing this affidavit to attest to the truth of the foregoing facts, to

facilitate re-issuance of the OR and/or to prove its lost, and for whatever legal
purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 27th day of

August 2019 in the City of Tanauan, Province of Batangas.

MARICRIS C. TERRADO
Affiant

SUBSCRIBED AND SWORN to before me this 27th day of August 2019 at

Tanauan City, Batangas affiant exhibiting to me her Philhealth Identification card
with number 05-251151937-3 to prove her identity.