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Affidavit of Damage To Vehicle

Nerio M Peregrino was driving a Honda City owned by Borough Financing Corporation with a passenger when a jeepney suddenly switched lanes and its spare tire hit the car's side mirror, breaking it off. As the jeepney drove on, the detached mirror was dragged against the car's side, causing dents and damage. The jeepney drove off without acknowledging fault in the hit and run accident. Peregrino executed this affidavit to attest to the truth of the events and support an insurance claim to repair the damage to the company vehicle.

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Lowind Tawi
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50 views1 page

Affidavit of Damage To Vehicle

Nerio M Peregrino was driving a Honda City owned by Borough Financing Corporation with a passenger when a jeepney suddenly switched lanes and its spare tire hit the car's side mirror, breaking it off. As the jeepney drove on, the detached mirror was dragged against the car's side, causing dents and damage. The jeepney drove off without acknowledging fault in the hit and run accident. Peregrino executed this affidavit to attest to the truth of the events and support an insurance claim to repair the damage to the company vehicle.

Uploaded by

Lowind Tawi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines) S.S.

City of ___________ )x - - - - - - - - - - - - - - x
AFFIDAVITOFDAMAGETOVEHICLE
I,
NERIO M PEREGRINO
, Filipino, of legal age, married, and COMPANYDRIVER of BOROUGH FINANCING CORPORATION
with office address at Unit 2105A n t e l G l o b a l C o r p o r a t e C e n t e r , J u l i a V a r g a s A v e n u e ,
O r t i g a s C e n t e r , P a s i g C i t y , Philippines, after being duly sworn to in accordance with law, hereby de
pose and state:1. That I am a duly licensed driver with Professional Driver's License No. N02-90-
144465 which is valid until 12 May 2011.2. That on 23 February 2010, at around 7:30 pm, I wa
s driving a vehicle, with Ninna G. Castro in the passenger’s seat, owned and registered in th
e name of BoroughFinancing Corporation which is more particularly described as follows:M a k e :
H O N D A E n g i n e N o . : L 1 3 Z 1 -
1 4 0 0 8 0 6 S e r i e s : C I T Y C h a s s
i s N o . : P A D G M 1 6 4 0 9 V 0 0
0 5 4 6 B o d y T y p e : S E D A
N P l a t e N o . : Z T L 1 7 7 MV
File No.:1340-
000004095993. That while I was slowly driving along Santolan Street, Cubao towards EDSA, a
passenger Jeepney which was on the opposite lane going to Katipunan Road, suddenly over too
k our traffic lane and the spare tire posed at the driver’s side of the jeepney hit the leftside mirr
or of our company vehicle. As a result, the entire left side mirror broke off fromthe said car’s body
and since that passenger jeepney was still moving forward, the detachedmirror was dragged onto the left side of
our car causing dents and further damage;4. That the said passenger jeepney drove away without acknowledgin
g its liability,therefore, a case of “hit and run” that even the plate number of the jeepney was impossibleto be asc
ertained;5. That there were no traffic enforcers at the time of the accident;6. That I am executing this Affidavit to
attest to the truth of the foregoing and insupport of the claim against the insurer for the repair of the damage ca
used to the saidcompany vehicle.
INWITNESSWHEREOF
, I have hereunto set my hand this ___ day of February,2010 at City of___________, Philippines.

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