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Affid Pareja 2022

sworn statement of pareja

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jephone enteria
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16 views1 page

Affid Pareja 2022

sworn statement of pareja

Uploaded by

jephone enteria
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 AGUSAN DEL SUR )SS


MUNICIPALITY OF SAN FRANCISCO )

AFFIDAVIT OF EXPLAINATION

I, RAMIL C. PAREJA, of legal age, Filipino, and a resident of


P-1, Townsite, Barobo, Surigao del Sur, after being duly sworn to in
accordance with law hereby depose and say:

(1)That in June 1, 2020 I acquired one (1) unit Suzuki Pick-up


with Canopy bearing Plate No. LNH736 from Junna L.
Pahayahay, copy of a Deed of Sale of Motor Vehicle hereto
attached as Annex “A”;

(2)That on October 13, 2021 at about 10:00 o’clock in the


morning at Brgy. Manyayay, Lianga, Surigao del Sur, the
above-mentioned unit involved in an incident, copy of the
Police Blotter hereto attached as Annex “B”;

(3)That as owner of said Suzuki Pick-up, I respectfully


request the motor vehicle’s insurance to release in my
favor whatever benefits and/or claims intended as owner
of the above-named unit;

(4)That I am executing this affidavit to support my claims in


motor vehicles’ insurance and for whatever purposes legal
and legitimate.

IN WITNESS WHEREOF, we have hereunto set my hands


this 27th day of May 2022 at San Francisco, Agusan del Sur.

RAMIL C. PAREJA
(Affiant)

SUBSCRIBED AND SWORN to before me this 27th day of


May 2022 at San Francisco, Agusan del Sur.

Doc. No. ___


Page No. ___
Book No. ___
Series of ___

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