REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF NON-RECEIPT AND LOSS

I,

RUBEN L. DOMDOM, of legal age, Filipino, and resident of #1 M. Ojeda

St., BF Resort Village, Las Pinas City, after being duly sworn to in accordance with
law, hereby depose and say that:
I am a holder of PLDT shares of stock under stock no. PLDTM 0001122064.
Said shares of stock certificate was mailed to me by PLDT on or about
October 1986.
To date, I have not received the said shares of stock certificate, thus, it was
lost.
Inspite of diligent efforts to look for shares of stock certificate all such
efforts proved futile and in vain up to this time, thus, I am declaring the loss of the
shares of stock certificate.
I am executing this affidavit to attest to the truth of the foregoing facts and
for all its legal intents, effects, consequences and purposes.

RUBEN L. DOMDOM
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this June 25, 2014 at Las
Pinas City.

Doc. No.

__

Page No. ___

Book No. ___
Series of 2014.

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I, ARLYN I. AGAPITO, of legal age, Filipino, and resident of 749 San Juan I,
Noveleta, Cavite, after being duly sworn to in accordance with law, hereby depose
and say that:
I am a holder of identification card (id) for authorization to drive, PLD-147
issued by PLDT.
2. On or about January 10, 2014 my said id was inadvertently got lost.
3. Inspite of diligent efforts to look for said id, all such efforts proved futile
and in vain up to this time, thus, I am declaring the loss said id.
4. I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes.

ARLYN I. AGAPITO
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this February 13, 2014 at Las
Pinas City.

Doc. No.

__

Page No. ___

Book No. ___
Series of 2014.

REPUBLIC OF THE PHILIPPINES)

LAS PIAS CITY

)S.S.

AFFIDAVIT OF LOSS
I, ROSEMARIE S. RAMBOYONG, of legal age, Filipino, and resident of Suite
12 2nd Floor Midland Plaza Hotel, M. Adriatico St., Ermita Manila, after being duly
sworn to in accordance with law, hereby depose and say that:
1.

I am a holder of

PLDT sim card

issued by Philippine Long Distance

Telephone (PLDT), with sim card no. (02) 697-25-57.

2. On or about last week my Nokia cellphone unit with said PLDT sim card
inadvertently got lost.
3. Inspite of diligent efforts to look for said cellphone unit and said sim card,
all such efforts proved futile and in vain up to this time, thus, I am declaring the
loss of the said cell phone unit and said sim card.
4. I am executing this affidavit to attest to the truth of the foregoing facts
and for all its legal intents, effects, consequences and purposes, including for the
issuance of same sim card number in lieu of the one lost.

ROSEMARIE S. RAMBOYONG
Affiant
SUBSCRIBED AND SWORN TO BEFORE ME, this November 11, 2013 at
Las Pinas City.

Doc. No.

439

Page No. 89
Book No. 75
Series of 2013.