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Republic 

of the Philippines)
Province of  Cavite ) S.S.
Municipality of Alfonso ) 

AFFIDAVIT OF LOSS
I, ARIEL ERNI PEPA, Filipino, of legal age, and with address at Brgy. Zambal,
Tagaytay City Cavite, Philippines, after being duly sworn to in accordance with law,
hereby depose and state:

1. That I am a regular subscriber/user of a Smart SIM Card with No. 0961 958 7024
registered with GCash;

2. However, on July 6, 2023, while I was in Alfonso Cavite I accidentally dropped


my phone containing the said SIM card and despite diligent search and efforts to
locate said cellular phone and SIM card, I could not find the same such that I now
believe that said is now lost beyond recovery;

3. As such, I am executing this affidavit not for any unlawful purpose but for any
valid and legal purpose only.

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of July, 2023
at Province of Cavite, Philippines.

ARIEL ERNI PEPA


Affiant

SUBSCRIBED AND SWORN to before me this 10th day of July, 2023 at Alfonso,
Cavite. Affiant exhibiting to me his D/L no. D11-18-008350 exp. 2023/11/25.

WITNESS MY HAND AND SEAL.

Doc. No. 153;


Page No. 32; ATTY. ENRIQUE G. BAUTISTA JR.
Book No. 12 ; NOTARY PUBLIC FOR THE PROVINCE OF CAVITE
Series of 2023. COMMISSION EXPIRES ON DECEMBER 31, 2024
ROLL OF ATTORNEY’S NO.52758
PTR NO. 5842958/ISSUED ON 01/9/2023 AT ALFONSO CAVITE
IBP LIFETIME No. 031665/01/30/2018
MCLE COMPLIANCE VII-0012699 VALID UNTIL APRIL 14, 2025

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