REPUBLIC OF THE PHILIPPINES)
CARMONA, CAVITE ) S.S.
AFFIDAVIT OF LOSS
I, ABEGAIL PUJANTE PIGAR, of legal age, single, Filipino citizen, and a resident of
425 Sitio Bayungan, Brgy. Kaong, Silang, Cavite, after having been duly sworn to in
accordance with law, do hereby depose and say:
1. That, I am the registered owner of a TOUCH MOBILE (TM) SIM Card bearing No.
09978632296;
2. That, my said TOUCH MOBILE (TM) SIM Card bearing No. 09978632296 is duly
registered in my G-Cash Account;
3. That, the same was on my possession for safekeeping; however, on November 20,
2023 at around 5:45 pm, my personal mobile phone containing said TOUCH MOBILE
(TM) SIM Card bearing No. 09978632296 was unnoticeably fell down around
Bayungan, Silang area. I have only noticed the same upon reaching our house; thus,
considered it lost;
4. That, I lost no time in diligently trying to locate the said TOUCH MOBILE (TM) SIM
Card bearing but all efforts proved futile and to no avail, and that the same is
considered lost and beyond recovery;
5. That, the said TOUCH MOBILE (TM) SIM Card bearing No. 09978632296 was never
confiscated by any other law enforcement agency for any violation;
6. That, I am executing this statement to attest to all the above facts and for the
purpose of informing concerned authorities regarding its loss for its replacement and
for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto affixed my signature this November 29,
2023 in Carmona, Cavite.
ABEGAIL PUJANTE PIGAR
Affiant
PIC ID No. 3906-8370-5286-1785
SUBSCRIBED AND SWORN to before me this this November 29, 2023 in Carmona,
Cavite. Affiant exhibited to me her Identification Card as proof of her Identity.
Doc. No. _____
Page No. _____
Book No. _____
Series Of 2023.