Republic of the Philippines)

Province of Tarlac ) S.C.

AFFIDAVIT OF LOSS

I, RYAN CARLO E. CARIÑO, of legal age, Filipino and a resident of Brgy. Bantog, Victoria,
Tarlac after having been duly sworn to in accordance with law, do hereby depose and say:

1. That I am a mobile phone with brand of Huawei 7 and mobile number, 09916849369;

2. That sometime in Oct. 28, 2022, while I was going to work, I did not notice that my
phone slip from my pocket;

3. That I continue to search for several days and exerted all my effort to find the same
but still could not find it.

4. That after exhausting all possible means to locate it, it is already beyond my control
to find the lost phone.

5. That I am executing this affidavit to attest to the truth of the foregoing

statements and inform the proper authority concerned about said lost phone and for
whatever legal purpose this affidavit may duly serve.

IN WITNESS whereof, I have hereunto set my hand this 3 rd day of November 2022 in
Victoria, Tarlac Philippines.

RYAN CARLO E. CARIÑO

Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of November 2022 in Victoria,
Tarlac Philippines, who exhibited to me his Competent Evidence of Identity.

Doc. No.
Page No.
Book No. 10
Series of 2022.