REPUBLIC OF THE PHILIPPINES)

CITY OF PASIG) S.S.

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

AFFIDAVIT OF LOSS

I, Caryll Pucong, of legal age, and a resident of 29 Jasmin St., Veterans

Village Pasong Tamo, Tandang Sora, Quezon City, after having been sworn to in
accordance with law, hereby depose and state:

1. That on 02 December 2020, while walking along MRT Ortigas

Station, my cellphone, Huawei Nova 3i, accidentally dropped on the ground;

2. That before I could get it, a male teenager immediately took it and
ran away;

3. That I tried to chase it but the teenager was running very fast;

4. That I was not able to follow the teenager anymore after he climbed
a wall;

5. That I tried to check with the other people around the area
regarding the whereabout of the culprit but nobody knew him and no one could
find him anymore;

6. That I exerted diligent efforts to locate and identify the culprit but
to no avail and I therefore considered the same as lost and cannot be found;

7. That I am executing this Affidavit to the truth of the foregoing facts

and to use the same for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 2 nd of

December 2020 at Pasig City, Philippines.

Caryll Pucong

This DOCUMENT was personally subscribed and sworn to by the affiant

before me this _______________ in Pasig City, Philippines. Affiant who is
personally known to me avowed under the penalty of law to the whole truth of
the contents of the foregoing instrument, and exhibited her UMID ID with
number CRN-0111-7021547-8.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my

Notarial Seal this _______________________ at Pasig City, Philippines.

Doc No. ______;

Page No. _____;
Book No. _____; NOTARY PUBLIC
Series of 2020.