Republic of the Philippines)

City of Zamboanga )s.s.

X---------------------------------X

AFFIDAVIT OF LOSS

I, AQUILES IGNACIO ZAMORA JR., of legal age, married, Filipino citizen, and a
resident of Lumbangan, Zamboanga City, Philippines, after having been duly sworn to
in accordance with law, hereby depose and say, that:

1. I am the owner of one (1) Samsung Galaxy A10 mobile phone unit containing
that certain TM prepaid SIM card bearing number 0906-869-6522;

2. However, on 25 June 2021 at 5 o’clock in the morning, while driving my

motorcycle from Zamboanga City Medical Center en route to my residence
and upon arriving at my residence I discovered that my mobile phone is no
long at my back pocket of my jean;

3. I exerted diligent efforts to look and locate for said cellphone containing said
SIM card in my residence and in other places, but all such efforts proved futile
and to no avail;

4. For all intents and purposes, I am now declaring the above-mentioned SIM
card lost and beyond recovery;

5. I make these statements under oath and in good faith in order to establish the
fact of loss of the above-mentioned SIM card;

6. I execute this Affidavit to attest to the truth of the foregoing facts based on my
personal knowledge and authentic records in compliance with the
requirement of the GLOBE Telecom, Zamboanga City of a SIM card in lieu of
the lost one and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand on this 25 th day of June

2021 at Zamboanga City, Philippines.

AQUILES IGNACIO ZAMORA JR

Affiant
Unified Multi-Purpose Identification Card no.
CRN-0111-3534592-7

SUBSCRIBED AND SWORN to before me on this 25th day of June 2021 at

Zamboanga City, Philippines. Affiant exhibited to me his competent proof of identity as
written above.

Doc. No. ____

Page No. ____
Book No. ____
Series of 2021.