AFFIDAVIT OF LOSS(LTO CERTIFICATE OF REGISTRATION)

Notice is hereby given that ROSALINA S. BALUYOT, was the absolute owner of a 2008 TOYOTA
FORTUNER 4X2 2. WAGON with Motor No. 2KD-7471896; Serial No. MR0ZR69G400008717; Plate
No. ZNF643 and MV File No. 1320- 00000229305. That she was issued by Land Transportation Office,
a Certificate of Registration No. 006377760, That the said LTO CR which kept inside the enveloped
together with her other important documents are missing, maybe someone stole it or slipped out
during travel or typhoon. That, she executing this affidavit to inform the Land Transportation Office of the
loss of CR, further warrant, undertake and justify the facts of their lawful ownership over the subject motor vehicle, to attest to the truth of the foregoing facts circumstances and for whatever legal purposes this may serve. Entered under notarial registry of Atty. Julliet T. Lopez, a notary public for the City of Iloilo on July 10, 2023 as per Doc. No. 463; Page No. 611; Book No. CXVII, Series of 2023.

The Capiz Times Publishing,
August 7, 14 & 21, 2023