REPUBLIC OF THE PHILIPPINES}

DONE: IN THE CITY OF BAGUIO } S.S.

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

AFFIDAVIT OF OWNERSHIP WITH UNDERTAKING

            I, NIKKI MAY A. MAGTALAS, of legal age, Filipino, single and a resident of No. 34 Ciudad
Grande, Bakakeng, Baguio City, Philippines  after having been duly sworn to in accordance with law, do
hereby depose and say that:

1. I am  the absolute and legal owner of  a GSM handset described as follows:

Make/Model:       SAMSUNG GALAXY S III - Black

International Mobile Equipment Identification (IMEI):  4754711148287792

2. On October 25, 2012, I executed an Affidavit of Ownership and Loss with Undertaking and filed
the same with the National Telecommunication Commission to authorize said commission and all
CMTS to block the said GSM handset for the reason that said cellphone was stolen from me by
unidentified person/s during a trip to Boracay;

3. However, on November 25, 2012, I was able to retrieve said GSM handset through a common
friend;

4. I hereby request/authorize the National Telecommunication Commission and all CMTS carriers to
unblock the said GSM Handset;

5. I hereby undertake to hold free from any responsibility or shall not hold NTC and the above-
mentioned carriers liable for whatever claims, loss or damages or any party may institute by
reason of NTC’s action to unblock the afore-mentioned unit;

6. In support of this request and as proof of my ownership of said cellphone unit, I attached hereto a
photocopy of the following documents:
A.                 Social Security System Identification Card Number 8835789
B.                 Professional Driver’s License No. AD-8885523122
C.                 Employment Identification Card No. SMC-02-1558
D.                 Police Report No. M-23145 (October 27, 2012)
E. Receipt No. SM-899975

7. I am executing this affidavit to attest to the truth of the foregoing facts and for whatever legal
intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 28th day of November 2012 in the City of
Baguio, Philippines.
__________________________
NIKKI MAY A. MAGTALAS
Affiant
Passport No. NN1245899

SUBSCRIBED AND SWORN to before me, in the City of Baguio, Philippines, this 28 th day of
November 2012, by Nikki May A. Magtalas, personally known to me, who is the same person who
personally signed before me the foregoing affidavit and acknowledged that he executed the same.

MARIA PHOENIX M. CHOA

Notary Public
Until December 31, 2014
Unit 3A, 3rd Floor, Porta Vaga Building,
Session Road, Baguio City
(074) 422-3287/ 09276435749
PTR No. 108083; 1-9-12/Baguio City
Roll of Attorney No. 101114; 1-9-12/
Baguio City
IBP Lifetime Membership No. 0821057;
Baguio-Benguet
MCLE No. III-0001178, 07-27-11
Doc. No. 19; Commission Serial No. 75-NC-11 (R)
Page No. 4; TIN: 922-596-319
Book No. I;
Series of 2012.