Republic of the Philippines)

City of________________)
x------------x
AFFIDAVIT

I, TESSIE D. LAMBUNAO, filipino, of legal age, president of JECMAT

Realty & Development Corp. with principal office address at Blk. 1 Lot 6
Mayon St. Amityville Subd. San Jose, Rodriguez, Rizal Philippines, after
being sworn to in accordance with law, depose and state:

1.That I am a duly licensed driver with Driver's License No.

N02-18-020535 covered by DLR No.032251761, which is valid until
March 17, 2023.

2. That on April 29, 2019, at around 9 o’clock in the morning, I was

driving a motor vehicle owned and registered under JECMAT Realty &
Development Corp. which is more particularly described as follows:

Make: Honda Civic 1.8L Non Turbo I-VTEC

Motor No.: R18Z16651321
Chassis No.: MRHFC6630JT020419
Plate No.: E0X172
Year Model: 2018

3. That while I was slowly to park my car at the parking area of our office,
the aforementioned vehicle suddenly hit the steep part of the garage as
a result the said vehicle sustained damage at its lower part of the
bumper;

4. That I am executing this Affidavit to attest to the truth of the forgoing

and in support of the claim against the insurer for the repair of the
damage caused to my vehicle.

IN WITNESS WHEREOF,I have hereunto set my hand

this___________in___________, Philippines.

TESSIE D. LAMBUNAO
AFFIANT

SUBSCRIBED AND SWORN to before me, this _____________,

by the affiant who exhibited to me his Competent Evidence of Identity No.
_____________ issued at _____________ on _____________

Notary Public
Doc. No. ______;
Page No. ______;
Book No. ______;
Series of ______;