Republic of the Philippines )

____________,_____________ ) S.S.

AFFIDAVIT OF LOSS

KNOW ALL MEN BY THESE PRESENTS:

I, RYAN JAY C. SANCHEZ of legal age, Filipino, married, and a resident of

______________________________________, after having been sworn in accordance with
law, hereby deposes and states the following:

1. I am holder/owner/ or possessor of Globe Prepaid Number ________________;

2. That on October 19, 2018, at around 11:00 am while on board a tricycle, my

cellphone was accidentally dropped from my pocket;

3. That upon arriving home, I discovered that my phone was already missing;

4. That I exhausted all possible remedies to be able to retrieve my phone but diligent
search proved futile and unavailing;

5. I execute this affidavit to attest to the truth of the foregoing.

Ryan Jay C. Sanchez

Affiant
(Signature over Printed Name)
Competent Evidence of Identity
ID:
Issued on:
at:

SUBSCRIBED and SWORN TO before me on the date and at the place indicated below. The
affiant exhibited to me his competent evidence of identity as indicated above.

Signed this ______________at ________________, ______________________, Philippines.

WITNESS MY HAND AND SEAL.

Notary Public

Doc. No.
Page No.
Book No. I
Series of