REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI )S.S

AFFIDAVIT OF CAR INCIDENT

I, GLENN M. ALIDON, of legal age, Filipino, single and with residence
address at 6922 Washington St., Brgy. Pio Del Pilar, Makati City, After having been
duly sworn to in accordance with law, do hereby depose and state:

That I am the registered owner of a motorcycle vehicle more particularly

described as follows:

MAKE/TYPE : HONDA/MC PLATE NO.: 948NVY

YEAR MODEL : 2020 CR NO. : 40189239-6
ENGINE NO. : JF78E7252216 OR NO. : 1985880993
CHASSIS NO. : K81N0002037 MV File No.: 1366-00000350217

That on July 27 2021 around 9:00 in the evening, I parked the aforementioned
motorcycle vehicle at Filmor Street near Cash and Carry Makati City. Upon returning
to my motorcycle vehicle, I noticed that their were scratches and dents all over my
motorcycle vehicle with some broken parts, which appears to be a hit and run by an
anonymous vehicle;

That the aforementioned situations was an incident beyond my control after

exercising extraordinary care and diligence to safety;

That I am executing this affidavit to attest to the truth of the foregoing facts
and for the purpose of an Insurance Claim in hands.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 30 th day

of July 2021 at the City of Makati.

GLENN M. ALIDON
Affiant

Subscribed and sworn to before me on the date first above written at the City
of Makati, and affiant exhibiting to me his Driver’s License ID No. G11-06-002244.

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Series of 2021