Republic of the Philippines}
City of Davao }S.S
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AFFIDAVIT OF ACCIDENT
I, JESSERY RUELO BAGUIO, of legal age, married, Filipino and
resident of Davao City, Philippines, after having been duly sworn to in
accordance with law, hereby depose and say that;
1. That I am the wife of Ramil Maningo Villarosa, owner of motor vehicle
described as follows:
Chassis Number : MMBGYKG40DD011373
Engine No : 4D56UCEJ5612
Model : 2013
Make : MITSUBISHI/MONTERO
Plate No. : LHJ741
2. That on or about 5:00 p.m. on June 12, 2014, while driving the above-
described vehicle and navigating in a reverse direction through the gate of our
neighbor at Hilltop Village, Bajada, Davao City, I accidentally bumped the said
gate causing damage to the left side rear portion as well as the rear door of the
said vehicle;
3. I am executing this affidavit to attest the truthfulness of the foregoing facts
and for whatever legal purposes it may serve.
IN WITNESS WHEREOF, We have hereunto affixed our signature this
June 30, 2014 in City of Davao, Philippines.
JESSERY RUELO BAGUIO
Affiant
SUBSCRIBED AND SWORN to before me this June 30, 2014 in City of
Davao, Philippines. Affiant personally appeared and showing to me her
Driver’s License ID No.L02-13-015275.
Doc No.308;
Page No.62;
Book No.35; RENE D. DE MANUEL JR.
Series of 2014 NOTARY PUBLIC
For & In the City of Davao
Valid Until December 31, 2015
Roll of Attorney No. 53431
PTR No. 3809200 12-18-13
IBP No. 847487 12-3-13
Commission Serial No. 106-2014