REPUBLIC OF THE PHILIPPINES )

CITY OF CAVITE ) S.S.

AFFIDAVIT OF LOSS

I, MARVIN JOHN LUGA JACA, of legal age, Filipino, and a resident of

708 Kalayaan St., San Antonio, Cavite City, after having been duly sworn to in
accordance with law, hereby depose and state:

1. That I am a lawful holder of Sim Card No. +63 938 720 2239 issued by
Talk ‘N Text Cellular Service;

2. That sometime on May 2020, I noticed that the said Sim Card were
missing;

3. Despite diligent search and efforts to locate the said Sim Card, I could not find the
same such that I now believe that it is now lost beyond recovery;

4. That I am executing this affidavit to attest to the veracity of the foregoing

facts and for whatever legal purpose it may serve under the law.

IN WITNESS WHEREOF, I have hereunto set my hand this 3 rd day of June,

2020 at Cavite City, Philippines.

MARVIN JOHN L. JACA

Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of June, 2020 at

Cavite City, Philippines, affiant exhibited to me his Identification Card.

NOTARY PUBLIC

Doc. No. 2918;

Page No. 58;
Book No.03;
Series of 2020.