REPUBLIC OF THE PHILIPPINES)

CITY OF ZAMBOANGA
) S.S.
x---------------------------------------x

AFFIDAVIT OF LOSS

I, Datu Abdel Khan K. Sawadi, of legal age, Filipino, single and a resident of
Sta. Catalina, Zamboanga City, after having been duly sworn to in accordance with
law, depose and state THAT:
1. On July 24, 2014, I was on my way to the Mosque with my Cellphone with the
Number 0927-666-1283 on the pocket of my pants;
2. After praying, I immediately search for my cellphone to text, but to my
surprise nowhere to find;
3. I had tried to look for the said cellphone in the Mosque as well in our house
and even tried to call it but to no avail and the same could not be found;
4. Despite diligent search and efforts to locate the said cellphone, I could not
find the same such that I believe that it is now lost beyond recovery;
5. As such, I am executing this affidavit to attest to the foregoing facts and to
support the application for the issuance of a new simcard with the same
number in lieu of the one which was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this 25th of July in
Zamboanga City, Philippines.

_____________________________
Affiant
Driver License No. ____________________

SUBCRIBED AND SWORN TO before me this 25th of July in Zamboanga City,

Philippines, affiant exhibiting to me his valid proof of identification.

Doc. No. ________;

Page No. ________;
Book No. ________;
Series of 2014.