AFFIDAVIT OF DAMAGE

 
 
        I, ALFONSO ROYALES PINTO, of legal age, Filipino, with
address at 23 Bacood St., Patubig, Marilao, Bulacan, after having
been duly sworn on oath  in accordance with law, hereby depose and
declare:
 
1. That I am the registered owner of the vehicle, more particularly
described as follows:

PLATE: NET 1268 COLOR: BLACK

MV FILE NO.: 1301-00001685312 SERIES: HI ACE GL GRANDI
ENGINE NO.: 1GD8641649 BODY TYPE: VAN
O.R. NO: 2110716226 C.R. NO.: 42132915-6
MAKE: TOYOTA ENGINE NO.: 1GD8641649
CHASSIS NO: JTFPA9APOLS018054 YEAR MODEL: 2021
              
2. That on or about December 25, 2020 at around 8:00 in the
morning, while I was maneuvering  the above described vehicle 
to drive for work, I noticed a damage at the back bumper of the
car;

3. I asked the by standers if they noticed who caused the damages

I was pertaining. Unfortunately, they cannot identify who caused
the said damage as the one who are drinking near my car on the
day of the 24th of December happened to be just visitors and
unknown to the bystanders;

4. They likewise hit the front bumper of my car leaving some

dents;

5. I execute this affidavit to attest that the damage sustained by

the car as described above was without the fault on my part and
was sustained the same by accident while it was unattended in a
parking lot.

6. That this Affidavit is executed for purposes of availing the

insurance for the repair of the damaged sustained.
 
 
ALFONSO ROYALES PINTO     
Affiant
 
 
SUBSCRIBED and SWORN to before me this ____ day of January
2020, affiant executed his Driver’s License with No. Co7-15-010619
showing his signature and picture to attest his identity thereof.
 
Doc. No.____
Page No. ___
Book No.____
Series of 2020