REPUBLIC OF THE PHILIPPINES ]

CITY OF CAGAYAN DE ORO ] S.S.

DRIVER’S AFFIDAVIT

I, JENITO VILLASIN ARNOCO, of legal age, Filipino and a resident of

Poblacion, Kumalarang, Zamboanga Del Sur, Philippines, after having been duly
sworn to an oath in accordance with law, hereby depose and say, that:

I am a duly licensed driver issued with Professional Driver’s License No. J03-
92-012974 by the Land Transportation Office (LTO), Cagayan de Oro City;

Sometime in December 2019, at around 11:00 o’clock in the afternoon, I was

travelling my way back to Cagayan De Oro City after attending a construction bidding
at Zamboanga City. I was driving the said vehicle being registered under my
employer’s name, JOSE EARL L. NAVARRO, under a Certificate of Registration No.
262454382 and Official Receipt No. 986303533 issued by the Land Transportation
Office, and is hereto more particularly described as follows:

MV FILE NO.: 1001-00000184306 ENGINE NO.: 1VD0353446

DENOMINATION: Sports Utility Vehicle MAKE: Toyota yt
SERIES: Land Cruiser 20 BODY TYPE: SUV
YEAR MODEL: 2017

Copies of Certificate of Registration No. 262454382 and Official Receipt No. 986303533
are hereto respectively attached as Annexes “A” and “B”.

On my way somewhere at Ipil, Zamboanga Sibugay, the vehicle in front of us

suddenly stop. To prevent the collision, I immediately applied my brakes. However, the
motorcycle at my back failed to maneuver and eventually bumped us. Then and there,
I alighted from my seat and made an inspection. However, the motorcycle driver has
managed to recover from the impact and immediately fled.

As a result of the above incident, my vehicle’s bumper guard at the back was
considerably damaged. A visible dent and scratches are also availing at the center
portion of the door at the back of my vehicle;

I am executing this affidavit to attest to the truthfulness of the foregoing

statements, to support our insurance claim for the repair of the said vehicle and for
whatever legal purposes this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 11 th day of February

2020 at Cagayan de Oro City, Philippines.

JENITO VILLASIN ARNOCO

Affiant
Driver’s License No. J03-92-012974

SUBSCRIBED AND SWORN TO before me this 11 th day of February 2020 at

Cagayan de Oro City, Philippines.

Doc. No.: ___:

Page No.: ___:
Book No.:___:
Series of 2020.