REPUBLIC OF THE PHILIPPINES)

RIZAL PROVINCE ) S.S.

AFFIDAVIT OF LOSS
I, DULCE MEA A. CUE , of legal age, single, Filipino, and a resident of Blk 16 Lot 27 Enoch St.
FH2, CSJDM, Bulacan after having been sworn to in accordance with law hereby depose and say
that:

1. I am a the recipient of SMART LTE 5G SIM # 09687901721 alocated and issued by the
Schools Division Office -Quezon City.

2. Last Wednesday June 15,2022 ,I find out that my cellphone got lost .

3. All my valuable items, including the Postal ID issued to me by PhilPost, were burned.

4. I was not able to save my valuable items and my Postal ID because when the fire
happened, I was at my work.

5. I execute this affidavit to attest to the truthfulness of the foregoing information, and to
secure another postal ID at PhilPost, and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___ day of September
2020 in Rodriguez, Rizal, Philippines.

JUAN DELA CRUZ

Affiant

SUBSCRIBED AND SWORN to before me this _____ day of September 2020 in

Rodriguez, Rizal, Philippines. Affiant exhibited to me his competent evidence of identity as
__________________.

Doc. No____;
Page No. ___;
Book No. ___;
Series of 2020.