From

XYZ
Address:
P.O ----------- PIN -------------
Ph: ---------------

Date. MM/DD/YYYY

To
The Police Officer In charge
ABC Police station, Address.

Sub. : SIM Card Lost Report

Sir,

While travelling from Hotel Heritage More towards Nibedita Road by

walking I lost my Mobile Phone SIM Card Ph. No. --------------- (BSNL
GSM) somewhere in that Pradhan Nagar Area on Saturday afternoon
MM/DD/YYYY.

Sir, to avoid any misuse of the above mentioned SIM Card I seek your
help and request you to kindly register an F.I.R in the subject matter.

For your ready reference I enclose herewith

(a) copy of lost SIM purchase Receipt
(b) copy of my as I.D proof.

Hope you will do the needful favourably at the earliest.

Thanks and regards

Yours Sincerely

____________ (signature)
XYZ