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Affidavit Car Accident ARAGON

The affidavit describes a car accident where the owner backed their Toyota Wigo into their house gate, damaging the left rear bumper. The owner signed an affidavit attesting to the details of the accident.

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RJ Banquerigo
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30 views1 page

Affidavit Car Accident ARAGON

The affidavit describes a car accident where the owner backed their Toyota Wigo into their house gate, damaging the left rear bumper. The owner signed an affidavit attesting to the details of the accident.

Uploaded by

RJ Banquerigo
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 the Philippines)

Province of Negros Oriental)s.s.


Municipality of Sibulan.…)

AFFIDAVIT ON AN ACCIDENT

THAT I, MA VIVIEN DURAN ARAGON, of legal age, single, Filipino, and a


resident of Rizal Street, Barangay Tinago, Bayawan City, Negros Oriental, after having
been duly sworn to in accordance with law, do hereby depose and manifest that:

I am the lawful owner of a motor vehicle particularly described as follows:


MAKE: TOYOTA
PLATE NO.: GAU5244
ENGINE NO.: 1KRA556106
MV FILE NO.: 0701-00001144929
CHASSIS NO.: MHKA4DF5FLJ045375
SERIES: WIGO 1.0 G AT
BODY TYPE: HATCHBACK
YEAR: 2021
CR NO.: 39853366-0

That on September 26, 2022, I was backing the above-mentioned vehicle in our
house in Rizal Street, Barangay Tinago, Bayawan City, Negros Oriental when the rear
portion of the said vehicle accidently hit the gate of our house;

After the incident, I noticed that the left side of the rear bumper of the above-
mentioned vehicle was damaged. There were scratches, dents, and damages on the the
left side of the rear bumper of the said vehicle as a result of the accident.

That this affidavit is executed freely and voluntarily to attest the veracity and
truthfulness of my statements herein.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 27 th day of


September 2022 in Sibulan, Negros Oriental, Philippines.

MA VIVIEN DURAN ARAGON


Affiant

SUBSCRIBED AND SWORN to before me, a Notary Public, on this 27 th day of


September 2022 for the Municipality of Sibulan and the Province of Negros Oriental,
Philippines, the above-named affiant, exhibited her PRC ID No. 0129242 valid until
08/25/2024, and WHO SIGNED IN MY PRESENCE the foregoing document
(AFFIDAVIT ON AN ACCIDENT), and who avows under PENALTY OF LAW to the
whole truth of the contents of the same.

Doc No. 102;


Page No.52;
Book No. VI;
Series of 2022.

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