AFFIDAVIT

I, JOSE DINDO CARLON RUTA, of legal age, married, Filipino

citizen, and a resident of Taloto District, Tagbilaran City, Bohol,
Philippines, after being duly sworn to in accordance with law, depose
and state that:

1. I am the owner of a certain parcel of land designated as Lot No.

3590 B-3, Plan No. PSD-07-093668 being a portion of Lot 3590-
B, PSD-071242-025453; 1104 located at Taloto District,
Tagbilaran City, Bohol, Philippines;
2. The above-mentioned lot is a portion of the Subdivision Plan
2008-13B-0110 under the name of Spouses Felix P. Oroc and
Cecilia I. Callenero;
3. A residential building is built/erected in the said portion;
4. I am executing this Affidavit of Loss to attest to the foregoing and
for any legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4th day

of February, 2019 in Tagbilaran City.

JOSE DINDO CARLON RUTA

Affiant
DL No: GO3-92-024288
Issued by: LTO

SUBSCRIBED AND SWORN to before me this 4th day of

February 2019 in the City of Tagbilaran, Bohol, Philippines,
affiant exhibited to me his competent proof of identity stated above.

Doc. No. _____

Page No. _____
Book No. _____
Series of 2019.