REPUBLIC OF THE PHILIPPINES…)

CITY OF CARCAR…………….)S.S.

AFFIDAVIT OF LOSS

I, HUXLEY GARCES, of legal age, single, and a resident of Brgy.

Bolinawan, Carcar City, Cebu after having been duly sworn to in
accordance with law, hereby depose and state that:

1. I am a holder of a HAWEI NOVA 7i mobile phone;

2. On September 15, 2021, I was travelling at Cebu City;

3. When I got home, I noticed that my phone was gone containing

a Subscriber Identity Module card (sim card) with
corresponding number, 09060685663 ;

4. I tried my best to locate my wallet but all efforts proved futile;

5. I am executing this affidavit to attest to the veracity of the

foregoing statements, and in compliance with the requirement
for the issuance of a new SIM CARD with the same number
and for whatever legal purposes it may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this

1st day of October 2021 at Carcar City, Philippines.

HUXLEY GARCES
Affiant

SUBSCRIBED AND SWORN TO before me this 1st day of October

2021 at Carcar City, Philippines.

Doc No. 121

Page No. 26
Book No. 4
Series of 2021.