Republic of the Philippines )

Province of Northern Samar ) S.S.

Municipality of Catarman )

AFFIDAVIT

I, MARIO P. IRINCO, of legal age, Filipino, and a resident of Catarman,

Northern Samar, after having been duly sworn in accordance with law, hereby depose
and state that:

1. I am the mechanic who repaired the motor-vehicle identified as FUSO

FIGHTER; PLATE No. CAZ2609; ENGINE No. 6M61-072110 owned and
registered in the name of ALEXANDER DAVID B. KRIST;

2. Upon assessment and after completion of the repairs, the overall damage
including the labor and parts used, amounted to ONE HUNDRED FIFTY
THOUSAND (Php 150,000) PESOS;

3. I am executing this affidavit to attest the truth and veracity of the foregoing
facts and to support the insurance claim pertinent to the above-described
motor vehicle as well as for other legal purposes this may serve best;

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my

signature this ___________________, Catarman, Northern Samar.

MARIO P. IRINCO
Affiant
ID No. 432-921-939-000
Issued by: BIR

SUBSCRIBED AND SWORN to before me this __________________ at

Catarman, Northern Samar.

Doc No. ______

Page No. _____
Book No. _____
Series of 2023.