REPUBLIC OF THE PHILIPPINES )

CITY OF CAVITE ) S.S.

AFFIDAVIT OF LOSS

I, REYCINIA B. ISLA, of legal age, Filipino, and a resident of 225 R. De Dios,

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. +63 919 621 3344 issued by Smart
Communications, Inc.;

2. That on July 03, 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. 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 12th day of July,
2019 at Cavite City, Philippines.

REYCINIA B. ISLA
Affiant

SUBSCRIBED AND SWORN to before me this 12th day of July, 2019 at Cavite
City, Philippines, affiant exhibited to me her Identification Card.

NOTARY PUBLIC

Doc. No. 1315

Page No. 55
Book No.03
Series of 2019.