REPUBLIC OF THE PHILIPPINES)

PROVINCE OF SURIGAO DEL SUR) S.S

AFFIDAVIT OF LOSS
KNOW ALL MEN BY THESE PRESENTS:

I, JOVELYN TEÑA, Filipino, of legal age and a resident of Catbalogan,

Samar, after having been duly sworn to in accordance with law, hereby depose
and state, THAT:

1. I have a GCASH Account under my name with GCASH registered

number: 0999-848-8827.

2. Unfortunately, I misplaced my sim card that that has my GCASH

Account.

3. Recently, I have discovered that said the sim card is irretrievably lost
and can no longer be found despite diligent efforts to locate the
same.

4. I execute this affidavit to attest to the truth of the foregoing and

whatever legal purposes it may serve best.

IN WITNESS WHEREOF, I have here unto set my hand this 22 th day of

March 2021 in the City of Bislig, Province of Surigao del Sur.

JOVELYN TEÑA
Affiant
ID No. ____________

SUBSCRIBED AND SWORN to before me on the date and place first above
written.

Doc. No. ____;

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