REPUBLIC OF THE PHILIPPINES)

CITY OF_______________________ )S.S.

AFFIDAVIT

I, ROMNEY CHRISTIAN E. GO, of legal age, Filipino, and resident of

# 664 Mary Grace Village Sto. Nino, Plaridel, Bulacan, after having been
sworn to in accordance with law hereby depose and state that:

1. That on November 18, 2022, I went to Cavite riding my own

Motorbike, from our residence in Bulacan to accompany my father
MR. ROMAN SANTOS GO to have my father’s Motorbike tuned-
up by his long time Mechanic in Cavite which we frequented;

2. That at around 8:19 in the evening on our way to eat dinner at

Tagaytay while traversing from east to west direction along
Tagaytay Calamba Road in Barangay San Jose, Tagaytay City in
front of City land Bldg, while taking the inner/fast lane towards
Tagaytay Rotonda a MONTERO SPORTS WITH PLATE
NUMBER NGM9840, traversing the Tagaytay Calamba Road in
Barangay San Jose, Tagaytay City from west to east direction
Driven by JERWIN AMOS BASBAS, RECKLESSLY AND
NEGLIGENTLY SUDDENLY TURNED LEFT, occupied and
blocked the lane of my father’s motorbike which resulted in a
Vehicle Collision between my father’s Motorcycle Bike and The
Montero Sports;

3. That after the collision, I immediately stop driving and rushed to

check on my father who was lying motionless on the ground, on-
looker pedestrians also rushed to help my father and called an
ambulance who immediately responded to the scene of the Vehicular
collision and brought my father to the nearest Hospital which is the
Tagaytay Medical Center, Inc.;

1
 4. That after the Unfortunate Incident I and JERSON AMOS BASBAS
the driver of the Montero Sports executed a document entitled
“MALAYANG SALAYSAY NG KASUNDUAN” wherein Mr.
Basbas plead for forgiveness and promised to shoulder all the Medical
expenses of my father including the Hospital Bills and all
Medications. Mr. Basbas further promised to Shoulder the expenses in
the repair of the Motor Bike of my father;

5. After several demands, the respondent reneged on his promise and

commitment to answer for the medical expenses and repair of the
damaged motorcycle;

6. That I am executing this affidavit freely and voluntarily for the

purpose of attesting to the truth of the foregoing statements, to inform
the proper authorities of the above facts, to support the complaint filed
by my father against JERWIN AMOS BASBAS and for whatever
purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this _____________th day of ____________________ 20___ at
______________________________, Philippines.

ROMNEY CHRISTIAN E. GO
Affiant

      SUBSCRIBED AND SWORN to before me this _____ day of

_________________ 20___ in _________________, Philippines. Affiant
exhibited to me his competent evidence of identity
_________________________.

_________________________