Republic of the Philippines )

Kawit, Province of Cavite….) Sc.

x--------------------------------------x

JOINT AFFIDAVIT
(of Vehicular Accident)

WE, XXXXX AND XXXXXX, Filipinos, both of legal age, and with respective
addresses at XXXXXXXXXX and XXXXXXXXX, after having been sworn in
accordance with law hereby depose and state that:

1. On December X, 20XX, at around XXXX noon, we were traversing the highway

of XXXX, Manila Bound.

2. I, XXX, was driving a XXX with Plate No. XXX with LTO Certificate of
Registration No. XXX dated XXX (V-1); while I, XXX, was driving a XXX with
Plate No. XXX with LTO Certificate of Registration No. XXX dated XXX (V-2).

3. We just passed the XXX XXX Toll Plaza at XXX, XXX with V-2 initially ahead
of V-1.

4. By reason of accelerated speeding, V-1 went ahead of V-2 running in front

thereof coursing the same path.

5. V-1 ran over something causing it to bounced. Upon bouncing, the gravels stuck
on the reserved tire at the back of V-1 fell on the ground and bounced to the front
windshield of V-2 causing it crack and sustain damage necessitating its immediate
replacement.

6. The afore narrated traffic incident was not immediately reported and recorded to
the proper police authority is by reason that I, XXX, am a grab driver with a
passenger bound to Manila at that time, while I, XXX, am bound to Pampanga to
pick up gravel for transport.

7. By reason of our above pressing schedule, we both agreed to report the incident to
the proper authorities immediately on the next succeeding business day and
secure a police report to claim from V-1’s insurance.

8. Upon reporting the said vehicular accident to the police, we were required to
execute an affidavit stating the subject accident. Hence, this Joint Affidavit.

9. Accordingly, we are executing this Joint Affidavit to attest to the truth of the
foregoing statements, to support our application to secure a police report of the
incident, to ultimately claim from the insurance of the V-1 and for whatever legal
purpose it may serve.

IN WITNESS WHEREOF, we have hereunto affixed our signatures hereunder this

XXX day of XXXX 20XX in XXXX, XXX.

XXX XXX
Affiant Affiant
XXX XXX

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 SUBCRIBED AND SWORN to before me on the date and place above written,
affiants exhibiting to me their competent evidences of identity as above stated bearing
their photographs and signatures.

Doc. No. ___.

Page No. ___.
Book No. ___.
Series of 20__.

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