You are on page 1of 1

Republic of the Philippines )

City of San Fernando )SS


Province of Pampanga )
x------------------------------------------x

AFFIDAVIT

I, ELEAZARETH A. VALENZUELA, Filipino, of legal age, and a resident of Block 79 Lot 18


Northville 14 Calulut 2000 City of San Fernando, Pampanga, after having been sworn in
accordance with law, voluntarily depose and state:

1. That I am a subscriber of Touch Mobile with No. 0905-757-8783;

2. That on May 5, 2018, my cellphone which contained said sim card was lost while I
was at the vicinity of Alfredos Resort, Baliti, City of San Fernando, Pampanga and
the same could no longer be found;

3. That diligent effort to locate said sim card proved futile;

4. I am executing this affidavit to attest the veracity of the foregoing facts


and circumstances and for whatever legal intent and purposes this may serve.

Copies of my Philippine Postal Identification Card are hereto attached as my proof of


identification.

IN WITNESS WHEREOF, I have hereunto set my hand this _______________ at the City of
San Fernando, Pampanga.

ELEAZARETH A. VALENZUELA
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME on the date and place stated above.

Doc. No.
Page No.
Book No.
Series of 2018

You might also like