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Affidavit of Accident in Support of Insurance Claim: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 4

Alva Marie C. Aguas files an affidavit to support an insurance claim for damage to her brother Roy Aguas' vehicle. On July 2020, while parking the Toyota Vios in reverse at an SM parking lot, she did not notice a post and bumped into it, damaging the rear right bumper and cracking the right tail light. She executes this affidavit to attest to the truth of the incident in support of the insurance claim and for any legal purposes. The affidavit is notarized by Attorney Princess L. Buan on August 4, 2020 in Porac, Pampanga, Philippines.

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97 views1 page

Affidavit of Accident in Support of Insurance Claim: IN WITNESS WHEREOF, I Have Hereunto Set My Hand This 4

Alva Marie C. Aguas files an affidavit to support an insurance claim for damage to her brother Roy Aguas' vehicle. On July 2020, while parking the Toyota Vios in reverse at an SM parking lot, she did not notice a post and bumped into it, damaging the rear right bumper and cracking the right tail light. She executes this affidavit to attest to the truth of the incident in support of the insurance claim and for any legal purposes. The affidavit is notarized by Attorney Princess L. Buan on August 4, 2020 in Porac, Pampanga, Philippines.

Uploaded by

tet1986
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Republic of the Philippines )

Porac, Pampanga ) S.S.

Affidavit of Accident in Support of Insurance Claim


I, ALVA MARIE C. AGUAS, of legal age, Filipino, and a resident
of Brgy. Poblacion, Porac, Pampanga, after having been sworn to in
accordance with law do hereby depose and say:

1. I am the person who drove a vehicle registered under the


name of my brother ROY AGUAS, particularly, Toyota Vios with Plate
No. CAJ4947.

2. Sometime on July 2020, at around 4:00 in the afternoon, I


was about to park said vehicle in reverse motion when I did not notice a
post stationed at SM parking lot. I bumped on the post causing damage
to the rear right side bumper and a crack on the right side tail light.

3. This Affidavit is executed to attest the veracity of the


foregoing in support of an insurance claim for the damage sustained by
the said vehicle and for whatever legal purpose this affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 4 th


day of August 2020 at Porac, Pampanga, Philippines.

ALVA MARIE C. AGUAS


Affiant
DL No. C10-11-014477
                                   
            SUBSCRIBED AND SWORN to before me, 4th day of August
2020 at Porac, Pampanga, Philippines affiant exhibited to me her
competent evidence of identity above indicated.   

ATTY. PRINCESS L. BUAN


Notary Public Until December 31, 2020
Commission No. 2018-730
Roll of Attorneys No. 66219
PTR No.: AC-1471505/ 01-07-20/Angeles City
IBP No.: 113403/ 01-13-20/ Pampanga Chapter
Unit 1-D PGD Bldg. Ortigas St. cor. Gen. Luna St.
Poblacion, Porac, Pampanga

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