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AFFIDAVIT

Date: 24.08.2023

The New India Assurance Co. Ltd,


CHENNAI, TAMIL NADU.

I, SUNDAR G, Residing at NO 30 CHINNAPPA STREET TRIPLICANE CHENNAI -600005.Hereby


state that my car Hyundai CRETA met with an incident on 05-08-2023 @ 08.00 am at
Hogenakkal, bearing Registration No. TN 06 Z 4795 Insurance policy No.
80000031230350077446 issued by The New India Assurance Co. Ltd.

I driving time of accident (DL NO-TN06 20120006101) in Hogenakkal when I try to


overtake a private bus unfortunately hit on that bus rear side and my vehicle got collided and
got damaged on front right side and took spot photos on the spot. I confirm that there is no
serious injury to any third party or damage to third party property whatsoever and in case any
third party liability arises in future as a consequence of the above. I declare that all the
liabilities, cost and expenses would bear by me and no way the insurance company is
responsible any such loss, now I am claiming own damages to my vehicle for which I hereby
undertaking to notify the same to you without fail.

SUNDAR G

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