REPUBLIC OF THE PHILIPPINES )

Province of Quezon ) S.S

Municipality of Gumaca )

AFFIDAVIT OF LOSS
I, ARTHUR B. ABELLA, of legal age, married, Filipino citizen and a resident of Brgy.
Poblacion, Buenavista, Quezon, after having been sworn to in accordance with law depose and
state:

1. That I own a cellular phone loaded with TNT SIM Card with Mobile No.
09636783187 which is subscribed to GCash which I use to send the allowance for my
children who are studying at St. Anne College and SLSU Tayabas;
2. That at around 12:30 in the morning of May 7, 2023, I dined at Jollibee Sto. Tomas,
Batangas and while eating, I put my cellular phone in the vacant chair beside me;

3. That I inadvertently left my cellular phone after eating and I drove my vehicle and left
the place;

4. That after a few minutes, I realized that my cellular phone is missing so I immediately
went back to the Jollibee and asked the guard if they happened to notice my cellular
phone;

5. That we tried to call my number and it rang for five times after which it could not be
contacted anymore;

6. That I asked the guard to check on their CCTV and the footage revealed that a male
person picked my cellular phone;

7. That I now consider my cellular phone irretrievably lost and beyond recovery for all
intent and purposes;

8. That I execute this affidavit in order to attest to the truth of the foregoing and to
explain the circumstances regarding the loss of my cellular phone with mobile number
enrolled with the GCash and in support of my request for the transfer of my GCash
balance to a new mobile number.

IN WITNESS WHEREOF, I have hereunto set my hand this 8 th day of May, 2023 at
Gumaca, Quezon.

ARTHUR B. ABELLA
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 8th day of May, 2023 at Gumaca,
Quezon, declarant is personally known to the Notary Public.

ROLANDO REBLEZA RECTO

Notary Public
My Commission expires December 31, 2024
Roll of Attorney No. 58282, May 4, 2010
IBP # 247375/; September 6, 2022/Quezon Prov.
PTR # 3425862; Jan. 3, 2023/Quezon Prov.
MCLE Compliance No. VII – 0010322, Feb. 16, 2022
Doc. No. 87
Page No. 19
Book No. XCII
Series of 2023