acknowledgement

Note:

(i) This is a digitally signed document

(ii) For verification visit 'Lost Articles Report' module on www.bcp.gov.in

(iii) Authority issuing duplicate document/article may obtain proof of identity

Disclaimer:

(i) This application is for lodging report of Article/Document lost in Bangalore only

(ii) Report lodged under this application is not a subject matter for enquiry/investigation

(iii) In case loss is due to theft or any other crime, contact nearest Police Station

(iv) False report to Police is a punishable offence

Karnataka State Police Form No.76A.

INFORMATION REPORT In respect of Article/Document Lost in Bangalore

P.S.: Crime Branch, Bangalore No.11807/2015 Date: 10/02/2015

Complainant Name: Silvia Mary Mammen

Date: 10/02/2015

Reason/Property Description: Cellphones/Tablets andAccessories/Mobiles/Smartphones/IMEI: 355673064663581Model Name: LG-D855Manufacturer: LGECarrier: AirtelLast activity seen on: Feb 10, 2015

Place: Koramangala

Inspector of Police CCRB, Bangalore