AFFIDAVIT OF ACCIDENT

I, JOANNE DONAIRE BAUTISTA, Filipino citizen, of legal age,

single, with postal and residence address at No. 711, 2F Medicion
II-F, Imus City, Cavite, Philippines, having duly sworn in
accordance with the law, do hereby depose and state, that:

1. I am the duly licensed driver with Professional Driver’s

License No. N03-22-302772;

2. Likewise, I am the registered owner of a motor vehicle

which is more particularly described as follows:

Certificate of Registration 438671461

Make TOYOTA
Series COROLLA 2.0V AV
Body Type SEDAN
MV File No. 1320-00000254138
Engine No. 3ZRX1039377
Plate No. TIC502

3. On October 30, 2022, at about 5:50 PM, the above-

mentioned motor vehicle was parked un-attended at along
Governor Ayong Maliksi Road, Brgy. Medicion II-F, Imus
City, Cavite, Philippines, when an un-identified motor
vehicle accidentally hit side-swiped left side portion from
left side bumper, left side driver seat-door, left side
passenger seat-door to left side rear bumper;

4. The aforementioned incident incurred long huge visible

scratches and dents at the left side portion of the
abovementioned motor vehicle;

5. Several eye witnesses from concerned citizens who were

at the place of incident who witnessed what really
transpired that evening and had gotten the plate number
particularly described as “UPT852”;

6. I am executing this affidavit to attest to the truth of the

foregoing facts and for whatever legal purpose it may
serve.

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 IN WITNESS WHEREOF, I hereunto affix my signature this
3rd day of October 2022, Imus City, Cavite, Philippines.

_____________________________________
JOANNE DONAIRE BAUTISTA
Affiant

SUBSCRIBED AND SWORN to before me this 3rd day of

October 2022, in Las Piñas City, Metro Manila, Philippines.

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