REPUBLIC OF THE PHILIPPINES )
PASIG CITY                 ) S.S.
                        AFFIDAVIT OF ACCIDENT
      We, ERICK MAGPAYO y NIDEA, Filipino, of legal age, married, and
residing at No. 110 Robles St., Manggahan, Pasig City, after having sworn in
accordance with law, do hereby depose and state that:
  1. My wife, Rowena Magpayo, and I are the owners of Suzuki Swift Dzire
     with plate no. UD 7880. The car, however, was registered under the
     name of my wife. As proof thereof a copy of the OR CR is hereto
     attached as Annex “A”. ;
  2. On or about 8:30 in the evening on March 30, 2017, we parked the said
     car in front of Lucky Gold Plaza to buy something in a nearby grocery.
     However, when we went out of Lucky Gold Plaza to get our car, we
     found out that there was a dent and several scratches in our car;
  3. The barker told us that a tricycle sideswiped our car while the same
     was parked in front of the Lucky Gold Plaza. Unfortunately, the barker
     was not able to get the plate number of the tricycle;
  4. I am executing this Affidavit to attest to the truth of the foregoing facts
     and for whatever purpose/s it may duly serve.
     AFFIANT FURTHER SAYETH NAUGHT.
     IN WITNESS WHEREOF, we hereby affix my signature this 31 st day of
March 2017 at Pasig City.
                                          ERICK N. MAGPAYO
                                                 Affiant
      SUBSCRIBED AND SWORN to before me this 31st day of March 2017
in Pasig City, Philippines, affiant exhibited to me as competent evidence of
identity his Professional Driver’s License with No. D19-04-000956 issued by
the Land Transportation Office.
                                             ATTY. MARCELINO C. ARCE, IV
                                                   Public Attorney II
                                                      Notary Public
                                                (pursuant to RA 9406)
Doc. No._____;
Page No._____;
Book No. _____;
Series of 2017.