Republic of The Philippines) City of Cavite) S.S. Affidavit of Loss

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REPUBLIC OF THE PHILIPPINES )

CITY OF CAVITE ) S.S.

AFFIDAVIT OF LOSS

I, FERNANDO S. BARRON, of legal age, married, Filipino, and a resident


of 115 Lino Barron St., San Antonio, Cavite City, after having been duly sworn to
in accordance with law, hereby depose and state:

1. That I am a lawful holder of Sim Card No. +63 915 740 0478 issued by
Globe Telecom;

2. That on October 13, 2019, I noticed that the said Sim Card were missing;

3. Despite diligent search and efforts to locate the said Sim Card, I could not find the
same such that I now believe that it is now lost beyond recovery;

4. Identifications submitted for proof of identity:

UMID No.: 4162-9801-0862-3041


Driver’s License No.: D06-90-067994

5. That I am executing this affidavit to attest to the veracity of the foregoing


facts and for whatever legal purpose it may serve under the law.

IN WITNESS WHEREOF, I have hereunto set my hand this 21 st day of


October, 2019 at Cavite City, Philippines.

FERNANDO S. BARRON
Affiant

SUBSCRIBED AND SWORN to before me this 21st day of October, 2019 at


Cavite City, Philippines, affiant exhibited to me his Driver’s License No. D06-90-
067994.

NOTARY PUBLIC

Doc. No. 1835


Page No. 154
Book No. III
Series of 2019.

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