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Republic of the Philippines ]

Province of Bohol ] s.s.

AFFIDAVIT OF LOSS

I, JOHN OCONNER, Filipino, of legal age, and a resident of TAgbilaran,


after having been duly sworn to in accordance with law, hereby depose and
state, that:

1. I am the owner and holder of a one (1) unit Globe cellular phone;

2. The said cellular phone was somehow lost and despite my diligent
effort to locate the same, the said Globe cellular phone can no longer be located;

3. The said Globe cellular phone was not confiscated, surrendered nor
captured by any constituted authority;

4. I am executing this affidavit to attest to the truth of the foregoing facts


for purposes of requesting the Globe Telecom Company to issue a new one in
lieu thereof and for whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this


_____________________- at ______________________.

NEAL VILLASOR QUIZON


Affiant

SUBSCRIBED AND SWORN to before me this 27th day of October


_____________________ at ____________________, Philippines, affiant
exhibiting to me his Identification Card No._________________

Doc. No. _____:


Page No. _____:
Book No. _____;
Series of 20.

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