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    Form No. NTC 1 24 AFFIDAVIT OF OWNERSHIP AND LOSS WITH UNDERTAKING R6

    Uploaded by

    Gavino Jr Gabo
    1. The document is an affidavit of ownership and loss with undertaking for a lost or stolen mobile phone. 2. It requests mobile carriers to block the IMEI and SIM card number of the lost phone to prevent further use. 3. The affidavit provides identifying information about the lost phone and owner. 4. The owner undertakes not to hold carriers liable for any claims related to blocking the lost phone.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Form No. NTC 1 24 AFFIDAVIT OF OWNERSHIP AND LOSS WITH UNDERTAKING R6

    Uploaded by

    Gavino Jr Gabo
    74 views1 page
    1. The document is an affidavit of ownership and loss with undertaking for a lost or stolen mobile phone. 2. It requests mobile carriers to block the IMEI and SIM card number of the lost phone to prevent further use. 3. The affidavit provides identifying information about the lost phone and owner. 4. The owner undertakes not to hold carriers liable for any claims related to blocking the lost phone.

    Original Description:

    Affidavit

    Original Title

    Form-No.-NTC-1-24-AFFIDAVIT-OF-OWNERSHIP-AND-LOSS-WITH-UNDERTAKING-R6

    Copyright

    © © All Rights Reserved

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    1. The document is an affidavit of ownership and loss with undertaking for a lost or stolen mobile phone. 2. It requests mobile carriers to block the IMEI and SIM card number of the lost phone to prevent further use. 3. The affidavit provides identifying information about the lost phone and owner. 4. The owner undertakes not to hold carriers liable for any claims related to blocking the lost phone.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    74 views1 page

    Form No. NTC 1 24 AFFIDAVIT OF OWNERSHIP AND LOSS WITH UNDERTAKING R6

    Uploaded by

    Gavino Jr Gabo
    1. The document is an affidavit of ownership and loss with undertaking for a lost or stolen mobile phone. 2. It requests mobile carriers to block the IMEI and SIM card number of the lost phone to prevent further use. 3. The affidavit provides identifying information about the lost phone and owner. 4. The owner undertakes not to hold carriers liable for any claims related to blocking the lost phone.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    REPULIC OF THE PHILIPPINES] S.

    S
    Form No. NTC 1-24
    ILOILO CITY]
    QUEZON Revision No. _ _____01
    Revision Date 03/31/2021

    AFFIDAVIT OF OWNERSHIP AND LOSS WITH UNDERTAKING

    I, _______________________________________________ of legal age, Filipino citizen and presently residing at


    _________________________________________________________________________with telephone number
    ______________________________________ and with office address at _______________________________
    and office telephone number ________________________________ law do hereby despose and say:

    1. That I am requesting all CMTS carriers to block the GSM handset that was lost/stolen in my possession by an unidentified
    person/s as owner thereof with particulars as follows:
    Make/Model/Type International Mobile Equipment Identification (IMEI)

    2. That I am also requesting to block the Subscriber Identity Module (SIM) card/cell phone number contained in the lost/stolen
    cell phone mentioned above;
    0 9
    0 9

    3. That I hereby undertake to hold free from any responsibility or shall not hold NTC and the above-mentioned carriers liable for
    whatever claims, loss or damages that any party may institute by reason of NTC’s action to permanently block the
    aforementioned unit from usage;

    4. That in support of this request and as proof of my ownership of said cell phone unit, I attached hereto the following
    documents, after making the original available for comparison;
    Copy of any government-issued ID OR Passport
    Copy of school ID (For students)
    Copy of Birth Certificate OR NBI Clearance (for cases when ID is not available)

    Proof of Ownership (ANY of the following):


    Copy of the Official Reciept of the mobile phone
    Box of the mobile phone with International Mobile Equipment Identity (IMEI)

    Additional Information:
    Lost/Misplaced Sex: Male Age: below 18 18-29 30-39
    Stolen (Theft/Robbery/Hold-up) Female 40-49 50-59 60 up
    Place of Incident
    Date Daytime Nightime

    5. That I am executing this affidavit of ownership and loss with undertaking to attest to the veracity and truthfulness of the
    foregoing declaration and to be used for whatever legal intent and purposes the same may thus serve.
    FURTHER AFFIANT SAYETH NONE.

    AFFIANT
    Signature Over Printed Name
    TIN No.

    Subscribed and sworn before me this ______ day of _______________, 20__. Affiant exhibited to
    me his/her Residence Cetificate No. ______________ issued at ______________on ____________.

    Doc. No.
    Page No.
    Book No. NOTARY PUBLIC
    Series of

    THIS FORM IS NOT FOR SALE AND CAN BE REPRODUCED

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