REPUBLIC OF THE PHILIPPINES )

City of Cotabato ) S.S.

AFFIDAVIT

I, Edwin Escote Caturas, Filipino, of legal age, and a resident

of Cotabato City, Philippines, having been duly sworn in accordance
with law, hereby depose and state:

1. That on or about 1:00 pm of October 24, 2018, a vehicular

accident transpired along the National Highway fronting
Gloria Spiritu residence, Purok 2-A, Brgy. Palian, Tupi, South
Cotabato;

2. That I am the driver of one of the vehicles involved in the

accident, bearing a Professional Driver’s License No. MO1-
04-000293 which will expire on August 18, 2023;

3. That the vehicle (herein referred as V-1) I am driving is a

Toyota Fortuner, with a color of silky gold mica metallic,
registered under the name of the Department of Health
Region XII, bearing a plate number of SKS-896;

4. That the other vehicle (herein referred as V-2) is a Honda Rs

Motorcycle, with a color of red, bearing a plate number of
LD 67024, and driven by Mark Corando Musa, 14 years of
old, residing at Sitio Atbangan, Brgy. Tuping, Tupi, South
Cotabato.

5. That per initial investigation of the Tupi Police Station, the

V-2 came from the left-east shoulder of the road and made
to enter the National Highway but unfortunately it
accidentally hit the left side portion of V-1 which appears to
be coming from the General Santos City heading to
Koronadal City. Thus resulting to the crashing down of the
V-2 to the pavement.

6. That the V-2 driver sustained slight physical injuries due to

the accident, and I immediately brought him to the nearest
Municipal Hospital for medical treatment, and was later
referred to South Cotabato Provincial Hospital for further
medication;

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 7. That both vehicles incurred undetermined amount of
damages and were held in custody by the Tupi Police Station
for further investigation and proper disposition;

8. That I am executing this affidavit to attest the truth of the

foregoing and for whatever legal purpose that this statement
may serve.

IN WITNESS WHEREOF, I have hereunto set my hands this

____ day of ____________ 2018 at ______________________,
Philippines.

EDWIN ESCOTE CATURAS

Affiant

SUBSCRIBED AND SWORN to before me, this ____ day of

_______ 2018 at ___________________, Philippines. Affiant exhibited
to me his _________________ issued on _______________ at
_______________.

NOTARY PUBLIC

Doc. No. ______

Page No. ______
Book No. ______
Series No. ______

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