REPUBLIC OF THE PHILIPPINES )

TUGUEGARAO CITY, CAGAYAN) S.S

AFFIDAVIT OF LOSS

I, JEREMIAH E. CANDO, of legal age, Filipino, and a resident of Greenview

Road, Atulayan Norte, Tuguegarao City, Cagayan and after having been sworn to in
accordance by law do hereby depose and say that:

1. I was issued a prepaid Subscriber Identity Module (SIM) Card bearing the
number 0919 843 1353 by the Smart Communications, Inc. (Smart);

2. That the above-mentioned simcard was linked or used to register/open an

account with Gcash;

3. That said sim card was inserted to an old phone which was damaged and wasn’t
used for a period of time;

4. That the said simcard was deactivated by Smart for non-loading of prepaid
credits for sometime;

5. That my son discarded the said simcard upon knowing that it was already
deactivated;

6. That we recently discovered that a friend of mine sent some amount to my Gcash
account where my said simcard was linked;

7. That the said simcard number is needed to open my Gcash account;

8. That efforts were exerted to locate said simcard but in spite of diligent search, it
could not be found and the same is now beyond recovery;

9. Hence, I am executing this affidavit to inform Smart of the fact about the loss of
the said simcard in view of the reasons stated above and to request for the
issuance of another simcard in lieu of the lost one;

IN WITNESS HEREOF, I have hereunto set my hand this ___ day of September 2022
in Tuguegarao City, Cagayan.

JEREMIAH E. CANDO
Affiant
TIN 277-738-302-000

SUBSCRIBED AND SWORN to before me this _____ day of September 2022 in

Tuguegarao City, Cagayan.

ATTY. PRINCESS KAE P. MALLILLIN

Docket No. _______ NOTARY PUBLIC
Page No. _______ VALID UNTIL DEC. 31, 2022
Book No. _______ PTR No. 3051910 / 01/04//2022
Series of 2022 Tuguegarao City, Cagayan
ROLL No. 71429 / MCLE COMP. VII