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Drivers Affidavit of David

John Lenard Abalos David, the owner and driver of a 2023 Toyota vehicle, reports an incident where his sister's car accidentally hit his car on August 7, 2023, causing damage to the front and rear bumpers. He is executing this affidavit to attest to the truth of the incident and to support his insurance claims. The affidavit was signed and sworn before a notary public in Manila City on August 29, 2023.

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Hasmin Perez
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2 views

Drivers Affidavit of David

John Lenard Abalos David, the owner and driver of a 2023 Toyota vehicle, reports an incident where his sister's car accidentally hit his car on August 7, 2023, causing damage to the front and rear bumpers. He is executing this affidavit to attest to the truth of the incident and to support his insurance claims. The affidavit was signed and sworn before a notary public in Manila City on August 29, 2023.

Uploaded by

Hasmin Perez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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REPUBLIC OF PHILIPPINES )

IN MANILA CITY ) S.S.

DRIVER’S AFFIDAVIT
(INCIDENT REPORT)

I, JOHN LENARD ABALOS DAVID, of legal age, Filipino and with residence address
at Lot 19 Block 8 Dahlia St. Treelane 3B, Bayan Luma, Imus City, Cavite, after having been
duly sworn to according to law, hereby depose and state:

1. That I am the owner/driver of a motor vehicle which is specifically described as follows:

MAKE : TOYOTA
MODEL : 2023
ENGINE NO : 1GD535521
CHASSIS NO. : MHFAA3GS2P0745468
PLATE NO. : Z3B572
MV FILE NO. :
OWNER NAME : ARMERAD CORNERSTONE CONSTRUCTION CORP.

2. That on 7th day of August, 2023 at around 11:00 am, while i was going out of my garage my
sister’s car accidentally hit my car at Dahlia St. Treelane 3B, Bayan Luma, Imus City, Cavite,
that the vehicle has concure a damage, the said vehicle on the following damages;

 Front Bumper
 Rear Bumper

3. That the said motor vehicle is insured with ______________________ under policy no.
_______________________;

4. That I am executing this affidavit in order to attest to the truth of the foregoing circumstances
and to support my claims with the said Insurance Company to where it was insured
comprehensively.

IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of August 2023 at
Manila City, Philippines.

JOHN LENARD ABALOS DAVID


AFFIANT

SUBSCRIBED AND SWORN to before me this 29th day of August 2023, in Manila
City, Philippines;

Doc No. _____;


PAGE NO. _____;
BOOK NO. _____;
SERIES OF 2023.

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