Republic of the Philippines)

City of Mandaluyong ) S.c.

AFFIDAVIT OF LOSS

  I, GHERO LOUIE MANZANO GUA-AN, of legal age, Filipino, married and

residing at Gua-an Compound, Purok 11, Manangkila St., Poblacion City of Valencia,
Bukidnon after having been duly to sworn in accordance with law, do hereby depose
and state that:

1. I am a holder of a Cellular Phone Samsung A12 and two Globe Simcard with
cellphone number 0917-519-9699 (postpaid) and 0915-703-8515(prepaid);

2. That the said cellular phone has a card case and my government issued ID’s
together with my ATM card in Bank of Commerce with account number 008-
2000-83327 we’re inserted inside the cellphone case.

3. Sometime in MRT Ortigas Station at February 10, 2023 around 5:30pm, the
said cellphone was stolen inside my bag pack, where I usually restore it and I
found out that my bag was opened and some of my things such as ID’s, ATM
Card and cellphone were stolen.

4. Efforts were exerted to recover the said cellphone, but in spite of diligent
search, it could not be found and the same is now beyond recovery;

5. As such, I am executing this Affidavit of Loss to attest to the truth of the

foregoing and to process my new postpaid and prepaid simcard account, to
process my ATM Card at Bank of Commerce, renewal or to process of new
Driver’s License.

IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of

March 2023 in Mandaluyong City, Metro Manila, Philippines.

GHERO LOUIE M. GUA-AN

Affiant

SUBCRIBED AND SWORN TO before me this 13th day of March 2023 at

Mandaluyong City Philippines, affiant exhibiting to me his competent evidence of
identity by way of National ID with No. 2875-6145-0932-4978.

NOTARY PUBLIC
Doc. No. ____;
Page No.____;
Book No.____;
Series of 2023.