REPUBLIC OF THE PHILIPPINES)

CITY OF TAGUIG) S.S.

AFFIDAVIT OF LOSS

I, Ma. Rojelyn Paulino, Filipino, of legal age and with office address at 18/F One
Park Drive, 9th Ave. cor. 11th Drive, Bonifacio Global City, Taguig, after having been duly
sworn in accordance with law, hereby depose and state the following:

1. I am a Globe Telecom subscriber with mobile number 0905-8336308;

2. In the morning of November 22, 2023, at or about eight o’clock, I was aboard the
LRT Line 1 during my commute to work when my mobile phone with the
abovementioned SIM number was pickpocketed from my belongings;

3. Earnest efforts have been exerted to locate said mobile phone but to no avail;

4. The aforementioned SIM was registered under my name in accordance with the SIM
Registration Act, and the same is linked to my Gcash and my bank accounts, among
others;

5. I execute this affidavit to attest to the truth of the foregoing and for any other legal
purpose it may serve; and for the purpose of requesting Globe Telecom for a
replacement SIM bearing the same number.

IN WITNESS WHEREOF, I have hereunto set my hand this 7 th day of December

2023 in Taguig City.

Ma. Rojelyn Paulino

Affiant

SUBSCRIBED AND SWORN to before me on the date and at the place above-
written, affiant exhibiting to me her BIR TIN 296-539-213-000.

Doc. No. _____;

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