Republic of the Philippines)

Lucena City……………….) S.S.

AFFIDAVIT OF LOSS

I, Jose Garizaldy C. De Luna Jr., of legal age and a resident of

Atienza Subd. Sariaya Quezon do hereby depose and state that:

1. I am the owner of a globe postpaid simcard with no.

09156883221;

2. Last September 9, 2018, my cellphone together with the said

sim card was lost;

3. Despite diligent effort in finding the same from the time it

was lost up to present, I failed to recover my cellphone and
its simcard;

4. I am executing this affidavit for whatever legal purpose it

may serve.

In witness whereof, I have hereunto affix my signature this 14th

day of September, 2018 at Lucena City, Philippines

Jose Garizaldy C. De Luna Jr

Affiant

SUBSCRIBED AND SWORN to before me this 14th day of

September, 2018, at Lucena City and I hereby certify that I have
personally examined the affiant and I am convinced that they
voluntarily executed and understood his affidavit.