Republic of the Philippines )

City of Cabanatuan ……….) s.s.

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

AFFIDAVIT OF LOSS

I, JANE JOIMIEFER CRISANTO, Filipino, of legal age, and resident of Kapt.

Pepe Subdivision, Cabanatuan City, after being sworn to in accordance with law, hereby
depose and state, that:

1. I am a Prepaid subscriber/customer of Globe Telecom, Inc. and was issued

with a SIM Card with Mobile No. 09567932020;

2. Sometime 2018, my father Juanito S. Candelaria borrowed the above-

described SIM Card so that he can use the same in his cellphone;

3. On August 2022, my father Juanito S. Candelaria died but when I tried to

locate his cellphone where the said SIM Card was inserted, the said cellphone could not
be found;

4. Despite diligent search and efforts to locate the said SIM Card and/or the
cellphone where it was inserted, I could not find the same, such that I now believe that
said is now lost beyond recovery or defective;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the

foregoing and in support of my request/application for the replacement of the said SIM
Card, and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of August,

2022 here at Cabanatuan City, Philippines.

JANE JOIMIEFER CRISANTO

Affiant
Non. Prof. Driver’s Lic ID No. CO5-18-006430
Expiry date: 2022/12/19

Subscribed and sworn to before me this 29 th day of August 2022 here at

Cabanatuan City.

Page No. NOTARY PUBLIC

Doc. No.
Book No.
Series of 2022.