Affidavit of Loss of Sim Card

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REPUBLIC OF THE PHILIPPINES)

MANDALUYONNG CITY) SS.

AFFIDAVIT OF LOSS

I, ISAIAS S. PASTRANA, JR., Filipino, of legal age, single, and a resident of Unit 1211 Bauhinia
Bldg., Tivoli Garden after having been duly sworn in accordance with law, hereby depose and say:

1. That I am a holder of a Globe Sim Card Number 09171668167.

2. That I used the said Sim Card on a RealMe GT Master Edition Device.

3. That sometime on June 10, 2023, when I went to San Juan, La Union, I discovered that my phone
was no longer in my bag where I used to place it;

4. That diligent effort to locate the same had proved futile.

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

IN WITNESS WHEREOF, I have hereunto affixed my signature this 14th day of June 2023 at
Mandaluyong City, Philippines.

ISAIAS S. PASTRANA, JR.


Affiant

SUBSCRIBED AND SWORN TO before me, a notary public in and for _____________________
this ____ day of ____________ 20___. The affiant, whom I identified through the following
competent evidence of identity: (TIN ID No. 287-187-513-000), personally signed the foregoing
instrument before me and avowed under penalty of law to the whole truth of the contents of said
instrument.

Notary Public

Doc. No. ........;


Page No. .......;
Book No. .......;
Series of 20__.

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