REPUBLIC OF THE PHILIPPINES)
CITY OF PASIG CITY ) S.S.
x----------------------------------x
AFFIDAVIT OF LOSS
I, EARL JUSTINE ENCARNACION of legal age, Filipino Citizen with residence and
postal address BLK 3 LOT 5 AND 7 SAN VICENTE HOMES SUBDIVISION, STA. MARIA
BULACAN after having been duly sworn to in accordance with law, depose and state THAT:
1. On September 13, 2023 my Sim Card issued by SMART COMMUNICATION with Sim
Card Number 09488185099 and my Cellphone was lost;
2. I had tried to look for the said Sim Card and Cellphone but could not be found;
3. Despite diligent search and efforts to locate the said Sim Card I could not find the same such
that I believe that it is now lost beyond recovery;
4. As such, I am executing this affidavit to attest to the foregoing facts and to support the
application for the issuance of a new one in lieu of the one which was lost.
IN WITNESS WHEREOF, I have hereunto set my hand this 18 th day of September,
2023 in City of Pasig, Metro Manila, Philippines.
_______________________________
EARL JUSTINE ENCARNACION
Affiant
SUBCRIBED AND SWORN TO before me this 18th day of September, 2023 in City of Pasig,
Metro Manila, Philippines, affiant exhibiting to me his valid proof of identification.
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2023.