Republic of the Philippines )

__________________ ) S.S.

AFFIDAVIT

I, _______________, Filipino, of legal age, married, and with residence at

__________________________________, after being duly sworn to in accordance with
law, hereby depose and state that:

1. I am a G-cash Subscriber with account number _______________ (old account);

2. On _______________, I discovered that said account number has been deactivated;

3. Said account has a Gcash balance of ___________________________

(PhpXXXX.XX) Pesos as of the date of deactivation;

4. Being deactivated, I cannot access my Gcash account, and thus cannot process any
transaction to transfer said balance to my new Gcash account with number
_________________________;

5. With this, I am formally requesting to GCASH to facilitate the transfer of

___________________________ (PhpXXXX.XX) Pesos from my old account
________________ to my new account __________________;

6. As such, I am executing this Affidavit of Loss to attest to the truth of the foregoing
and to support my application recover my money from my old Gcash account and
be transferred to my new Gcash account number.

IN WITNESS WHEREOF, I have hereunto set my hand this ___________________ at

____________________.

________________________
Affiant

SUBSCRIBED AND SWORN to before me in _________________ this

__________________ by the affiant, who has satisfactorily proven her identity to me through
_________________________ issued in _____________________, that she is the same person
who personally signed the foregoing affidavit before me and acknowledged that she executed the
same.

Doc. No. __;

Page No. __;
Book No. __;
Series of 2023.