Aff of Loss Sim Card

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REPUBLIC OF THE PHILIPPINES)

PROVINCE OF NUEVA ECIJA )S.S.


SCIENCE CITY OF MUNOZ )

AFFIDAVIT OF LOSS

I, ___________, of legal age,single, Filipino, and with residence at


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

1. I am a Touch Mobile subscriber with card number _____________;


2. Sometime in June 28, 2019, I was on board in a Van on my way to Zambales.
When upon reaching my destination, I discovered that the said SIM card which I
inserted at the casing of my phone is already missing which most probably fell
off.
3. I exerted due diligence to locate the same but all proved futile as the same could
no longer be located;
4. I am executing this affidavit to attest to the truth of all the foregoing statements
and for purposes of attesting to the circumstances surrounding the loss of my TM
sim card with number _________________, for purposes of securing a
replacement for the same and for all legal intents and purposes this may serve.

IN TRUTH WHEREOF, I have hereunto affixed my signature this 30 th day of


August 2019 at _________________.

_____________
Affiant
ID No.
Issued by:

SUBSCRIBED AND SWORN TO before me this 30 th day of August 2019 at


______________, affiant exhibiting to me hercompetent evidence of identity.

Doc. No. _______


Page No. _______
Book No. _______
Series of 2019.

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