Republic of the Philippines ]

]
AFFIDAVIT OF CAR ACCIDENT
I, MELANIE CRUZ, of legal age Filipino citizen with postal address at Room No. 211 Pacific
Regency Building No. 760 Pablo Ocampo Street, Malate, Manila City, after having been duly sworn to in
accordance with law do hereby depose and say:
A. That I am the owner/authorized driver of a certain motor vehicle, more particularly
described as follows;
Unit
Plate No.
Chassis No.
Motor No.

: 2014 HONDA CITY 1.5 VX CVT SEDAN

: DP6839
:PADGM6630EV002736
: L15Z11404854

B. That on October 17, 2015 at around 4:50 PM in the afternoon, I parked the above
mentioned vehicle along San Andres near Quirino Avenue, Malate, Manila.
that when I came back after 2 hours, I discovered that the there were already
damage in RH front bumper and several markings or vandalisms made on the left
hand quarter panel & trunk lid cover of the said vehicle.
C. That I have no knowledge of facts indicating as to who was responsible for the said
damages on the incident narrated in the preceding paragraph.
I am executing this affidavit to inform all concerned about this accident.
In witness Whereof, I have hereunto set my hand this ______ day of ______________ 2015
In Manila City, Philippines.
MELANIE D. CRUZ
Affiant
Subscribed and sworn to me, before this ______ day of ______________ 2015 in Manila City
Philippines.
NOTARY PUBLIC
Doc No.
Page No.
Book No.
Series of

Republic of the Philippines ]

]
AFFIDAVIT OF CAR ACCIDENT
I, MELANIE D. CRUZ, of legal age Filipino citizen with postal address at Room No. 211 Pacific
Regency Building No. 760 Pablo Ocampo Street, Malate, Manila City, after having been duly sworn to in
accordance with law do hereby depose and say:
A. That I am the owner/authorized driver of a certain motor vehicle, more particularly
described as follows;
Unit
Plate No.
Chassis No.
Motor No.

: 2012 HONDA CRV WAGON

: WKO-618
:JHLRM1820CC200519
: R20A51511008

B. That on August 23, 2015 at around 8:50 AM in the morning, I parked the above
mentioned vehicle along Arellano Avenue near Puregold-Osmea, Malate, Manila.
that when I came back after 3 hours, I discovered that the there were already
several markings, dents or vandalisms made on the left & right side or different
portions of the said vehicle.
C. That I have no knowledge of facts indicating as to who was responsible for the said
damages on the incident narrated in the preceding paragraph.
I am executing this affidavit to inform all concerned about this accident.
In witness Whereof, I have hereunto set my hand this ______ day of ______________ 2015
In Manila City, Philippines.
MELANIE D. CRUZ
Affiant
Subscribed and sworn to me, before this ______ day of ______________ 2015 in Manila City
Philippines.
NOTARY PUBLIC
Doc No.
Page No.

Book No.
Series of

ODUGAR TRUCKING SERVICES, INC.

Dove St., Area 4 Sitio Veterans Bagong Silangan Q.C.

July 11, 2015

ATTN: SIR JEORGE D. UMPOC
ASSISTANT CLAIMS MANAGER
ALPHA INSURANCE
Dear Sir,
I would like to authorized MR. RANILO MARAHAY to get our check from your good office as our claim w/
date of accident last May 08, 2015 as a third party of SONNY/MARY ANN CANDELARIA amounting Thirty
Thousand Pesos (P30, 000.00) .

Im hoping for your approval for this matter,

Thank you.

Respectfully Yours

AURORA C. RAGUDO