REPUBLIC OF THE PHILIPPINES)

_____________________________ ) S.S.

AFFIDAVIT OF LOSS

I, Charles John M. Villareal, of legal age, Filipino, with address 3 Banahaw

Street Greenwoods Exec. Village Cainta Rizal, having been sworn in accordance with
law hereby depose and state that:
1. On November 6, 2023, while I was going to home from BIR Main Office in
Quezon City, I was in commute when I notice that my Bar phone was lost;
2. That Phone with contact number of 09304673121 is used as one of my
primary contacts used in business matters and other matters which are
important;
3. I went back to the building premises and ask the guard on duty if they
notice any personal things such as m bar phone. The guard says they did
not notice nor any report of any lost Phone in the vicinity;
4. I took the pains in searching for my phone but to no avail;

Signed ______ day of ________, 2023 at ________________________

CHARLES JOHN M. VILLAREAL

Affiant

SUBCRIBED AND SWORN to before me this____ day of ________________________

at the City of ___________________ affiant exhibiting to me his
______________________________

Doc. No. : ________;

Page No. : ________;
Book No. : ________;
Series of 2023.