Republic of the Philippines)

, ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, Marden Gacutan Encarguezof legal age, Filipino, married, and a resident of Maralit
Compound, Mt. Apo St., Soldiers Hills 4, Molino 6, Bacoor, Cavite, after having been sworn
in accordance with law, hereby deposes and states the following:

1. That, I am a Subscriber of Globe Postpaid Mobile Number 09171860629 and

Globe Mobile Prepaid 09270559583;
2. That, I have lost my Mobile Phone wherein the said Sim Cards are inserted;
3. That, the said phone can no longer be found despite diligent efforts to locate the
same;

4. That, I am executing this affidavit to request from Globe Inc. replacement of my lost sim
cards,

Affiant, sayeth naught.

MARDEN G. ENCARGUEZ
Affiant
SSS Number : 03-9912740-3

SUBSCRIBED and SWORN TO before me on the date and at the place indicated below. The
affiant exhibited to me her competent evidence of identity as indicated above.

Signed this at , ,

Philippines. WITNESS MY HAND AND SEAL.

Notary Public

Doc. No.
Page No.
Book No.
Series of
2019