REPUBLIC OF THE PHILIPPINES)

CITY OF MANILA ) S.S.

AFFIDAVIT OF LOSS
I, Camille Angel Tolentino, of legal age, single, Filipino, and a resident of 412 AH Lacson
Street Sampaloc Manila, after having been sworn to in accordance with law hereby depose
and say that:

1. I am the owner of the following (“object”):

Globe Simcard with cellphone number : 09459718345

2. On or about 01 September 2021, I discovered that the lost of the said object under
the following circumstamces:

I keep my cellphone in my bag. When I needed it, I discovered that my cellphone

with my simcard inside it is not in my bag.

3. Despite diligent efforts, I could not find nor locate the same and I believe it is truly
lost.

4. 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 7 th day of April 2022 in
the City of Manila, Philippines.

CAMILLE ANGEL A. TOLENTINO

Affiant

SUBSCRIBED AND SWORN to before me this _____ day of April 2022 in the City of
Manila, Philippines. Affiant exhibited to me his competent evidence of identity as
__________________.

Doc. No____;
Page No. ___;
Book No. ___;
Series of____.