Republic of the Philippines)

City of Davao………………) S.s.

AFFIDAVIT OF LOSS

I, RICHIE JAY MICHAEL ORIDA, of legal age, single, and a

resident of Blk 1, Lot 18, Cecilia 1, Cabantian, Davao City, after having
been duly sworn to according to law do hereby depose and state that:

1. I am a TNT Telecom subscriber with SIM Card No. 09105092020.

2. Sometime around September 23, 2023, when I’m checking my

personal belongings, I discover that the above-mentioned items are
no longer in my personal belongings or in my house.

3. I looked for it all over my house, but it was no longer to be found.

4. Despite diligent efforts exerted, I could not locate or recover the

said SIM card, and to my best knowledge, the same is truly lost.

5. The said SIM card has not been confiscated by any officer of the
law or the issuing agency or office due to the violation of any law,
statute, order, rule, or regulation.

6. I am executing this affidavit in order to attest to the truth of the

foregoing circumstances and to request the issuance of a new SIM
card to replace the one that was lost.

IN WITNESS WHEREOF, I have hereunto set my hand this 16 th day of

October 2023 in the City of Davao, Philippines.

RICHIE JAY MICHAEL ORIDA

Affiant

SUBSCRIBED AND SWORN to before me this 16th day of October

2023 in the City of Davao by LARA MAE PADECIO with Philippine
Passport I.D No. P4210874C issued on May 22, 2023 valid until May 22,
2033 at DFA, Manila, Philippines.

Doc. No.___;
Page No.___;
Book No.___;
Series of 2023.