REPUBLIC OF THE PHILIPPINES)

C I T Y O F M A K A T I ) S.S.

AFFIDAVIT
Sworn Statement
That I, ARIEL Q. GAYONA, of legal age, Filipino citizen, with residence address at
2123 Gallarza St., San Andres, Bukid Manila, Philippines, after having duly sworn to in
accordance with the law do hereby depose and state that:

That I am the Authorized Driver of the Public Utility Vehicle with Plate No. DDK-209;

That last 10 July 2017, somewhere along Brgy. Tejeros near Puregold, that I have
been arrested by BJON U. REVECHO for assaulting traffic officer due to a traffic violation,
hence my jitney was impounded at MMDA Impounding, located at Quezon City;

That I am the Authorized Driver of that jitney and I agreed that traffic enforcer MR.
BJON U. REVECHO and I has amicably settled and no case will be filled by the former;

That I would like to state under oath that I will not file a case as a result of the
settlement that has been agreed by traffic enforcer MR. BJON U. REVECHO and I, further I
will not demand on any damages between us of the traffic enforcer MR. BJON U.
REVECHO;

I am executing this affidavit to attest to the truth of foregoing facts and to inform the
proper authorities concerned and for whatever legal purpose this affidavit may serve.

AFFIANT FURTHER SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereunto set my hand on this 11th day of July 2017, in the
City of Makati.

ARIEL Q. GAYONA
Affiant

SUBSCRIBED AND SWORN to before me on this 11 th day of July 2017, in the City of
Makati.

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SERIES OF : 2017.