Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Republic of the Philippines ) Province of Pampanga ) S.S.

Angeles City ) AFFIDAVIT OF LOSS I, RONALD GARCIA, Filipino, of legal age and a resident of 2574 Mabini St., San Nicolas, Angeles City, Philippines, after being duly sworn in accordance with law, depose and state that: I am a regular subscriber/user of a Smart Mobile SIM Card with No. 09089446670; Yesterday, I discovered that my cellular phone was missing together with my said Mobile SIM Card which was inside it; Despite diligent search and efforts to locate said cellular phone, I could not find the same such that I now believe that said is now lost beyond recovery together with the aforesaid SIM Card; As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing and in support of my request/application for the replacement of the said SIM Card. IN WITNESS WHEREOF, I have hereunto set my hand this 14th day of June, 2012 at Angeles City, Philippines.

RONALD GARCIA Affiant SUBSCRIBED AND SWORN to before me, this 14th day of June, 2012, by the affiant who exhibited to me his Non-Professional Drivers License with No. C10-03007326 valid until 2013-04-06.

Doc No. ___; Page No. ___; Book ___; Series of 2012.

You might also like