AFFIDAVIT

I, PRASAD B.S., S/o Shivalinge Gowda, residing at .........do hereby solemnly

affirm and declare as under:
 : 2:

That I am the Owner of Access 125 CC with Registration No.KA02 KC9793.

I was travelling in my Two Wheeler from my work place to my home, where in
I was driving my two wheeler near Nayanadahalli, Ring Road, due to heavy rain
the vehicle got skid and fell down and hit the divider. Resulted in damaging the
two wheeler on 12-06-2020 at around 8:30 p.m.

I confirm that no bodily injury or death has been occured to anyone due to this
accident, since I have not filed a FIR with police.

I confirm that it is completely my responsibility if there are any bodily injuries

or death.

Report because of the above accident caused on 12-06-2020 about 8:30 p.m.

I solemnly affirm and declare that this affidavit of mine is correct and true to
best of my knowledge and no part of it is false and nothing material has been
concealed therein.

DATE : 04-07-2020

PLACE: Bangalore DEPONENT