Republic of the Philippines )

Dasmariñas City, Cavite ) S.S

AFFIDAVIT OF LOSS

I, JEATZ T. PARAGUAS, in legal age, Filipino citizen, single and a resident of Blk
21 Lot 32 Country Meadow Subd. Brgy. San Francisco General Trias City, Cavite, after
having been duly sworn to in accordance with law do hereby depose and say THAT;

1. I am subscriber of TM Mobile SIM Card with No. 09351448998 and Smart Mobile
SIM Card No.09993183391;

2. On December 05, 2018 in the afternoon, I boarded a passenger jeepney from

Brgy. Sampaloc 1, Dasmariñas City, Cavite going to Brgy. San Francico General
Trias City, Cavite. I brought with me my smart phone (ASUS MAX);

3. While in transit, I discovered that my mobile phone was missing together with the
said Mobile SIM Cards which was inside the said cellular phone;

4. Right away, I searched for it underneath my seat but I found nothing. Also I asked
some of my co-passengers if they have seen the same but all answered in the
negative;

5. All the diligent efforts exerted to locate my mobile phone and SIM cards proved
futile; hence, I now consider them as lost and beyond recovery;

6. I am executing this affidavit to attest to the truth of the foregoing statements and
for all legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 12th day of

December, 2018 at Dasmariñas City, Cavite.

JEATZ T. PARAGUAS
Affiant

SUBSCRIBED AND SWORN to before me on the date and place indicated above.
Affiant exhibited before me NBI Clearance with ID No. M545JNPR29-RD456265 issued on
04 January 2018.

NOTARY PUBLIC

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Series of 2018.