REPUBLIC OF THE PHILIPPINES )

City of Tarlac ) S.S.

x------------------------x

AFFIDAVIT OF LOSS

I, RENZO F. GABATINO, of legal age, Filipino, and a resident of San

Nicolas, Victoria, Tarlac, Philippines after having been duly sworn in
accordance with law, hereby depose and say that:

1. I am a regular user of a Globe Mobile Subscriber Identity Module (SIM)

Card with No.09776897525 since December 2018;

2. On 26 April 2019, at about noontime, the above-said SIM Card was

lost/missing;

3. I failed to recover the said SIM Card despite diligent search and
earnest efforts to locate it, and I consider the same as lost and can no
longer be found;

4. I am executing this Affidavit to attest to the truth of the foregoing

facts and in support of my application for the replacement of the said
SIM Card and for whatever legal intents and purposes it may serve.

Affiant states nothing further.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 30 th

day of April 2019 in Tarlac City, Philippines.

RENZO F. GABATINO
Affiant

SUBSCRIBED AND SWORN TO before me this 30th day of April 2019 in

Tarlac City, Philippines.

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