Republic of the Philippines)

Province of_________________) S.S.

City/Municipality of____________)
x------------x
AFFIDAVIT OF LOSS
I,DANAH BIANCA Q. RAMOS, Filipino, of legal age and a resident of
BRGY.KALAWAAN, CITY OF PASIG METRO MANILA, Philippines, after being
duly sworn in accordance with law, depose and state:
That I am a regular subscriber / user of a Talk N Text Mobile SIM Card with
No. 09097289731;
That in the night of May 22, 2015, I rode a transport vehicle from work to
home, as I enter inside my house I found that my Nokia cellular phone with
the said SIM Card in it was missing.
That despite diligent search and efforts to locate said cellular phone, I could
not find the same such that I now believe that said is now lost beyond
recovery together with the aforesaid SIM Card;
As such, I am executing this Affidavit of Loss to attest to the truth of the
foregoing and in support of my request /application for the replacement of
the said SIM Card.
IN WITNESS WHEREOF,I have hereunto set my hand this 25th of May 2015 at
City of Pasig, Philippines.

Affiant
Danah Bianca Q. Ramos