REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY )S.S.

AFFIDAVIT OF LOSS

I, EDGARDO M. AGAS, of legal age, Filipino, and resident of Fatima St., San
Antonio Valley I, Paraaque City, after being duly sworn to in accordance with law,
hereby depose and say that:

1. I am a holder and owner of a Sun sim card no. 0922-861-8381.

2. On December 9, 2011, my Nokia cellphone unit with said sim card

inadvertently got lost.

3. Inspite of diligent efforts to look for said cellphone unit and said sim card,
all such efforts proved futile and in vain up to this time, thus, I am declaring the
loss of the said cell phone unit and said sim card.

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

and for all its legal intents, effects, consequences and purposes, including for the
issuance of same sim card number in lieu of the one lost.

EDGARDO M. AGAS
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME, this December 10, 2011 at

Las Pinas City.

Doc. No. 501

Page No. 102
Book No. 52
Series of 2011.