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    Affidavit of Damage To Vehicle

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    roxsanne capati
    Roel G. Villanueva owns a 2019 Toyota Rush that was damaged on May 21, 2020. While parking the vehicle in his garage, he accidentally hit the concrete pole of his gate, causing dents and scratches on the left rear portion. He filed an affidavit to attest to the details of the accident and damage to his vehicle to support his insurance claim.

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    © All Rights Reserved
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    Affidavit of Damage To Vehicle

    Uploaded by

    roxsanne capati
    473 views1 page
    Roel G. Villanueva owns a 2019 Toyota Rush that was damaged on May 21, 2020. While parking the vehicle in his garage, he accidentally hit the concrete pole of his gate, causing dents and scratches on the left rear portion. He filed an affidavit to attest to the details of the accident and damage to his vehicle to support his insurance claim.

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    affidavit of damage to vehicle

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    Roel G. Villanueva owns a 2019 Toyota Rush that was damaged on May 21, 2020. While parking the vehicle in his garage, he accidentally hit the concrete pole of his gate, causing dents and scratches on the left rear portion. He filed an affidavit to attest to the details of the accident and damage to his vehicle to support his insurance claim.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    473 views1 page

    Affidavit of Damage To Vehicle

    Uploaded by

    roxsanne capati
    Roel G. Villanueva owns a 2019 Toyota Rush that was damaged on May 21, 2020. While parking the vehicle in his garage, he accidentally hit the concrete pole of his gate, causing dents and scratches on the left rear portion. He filed an affidavit to attest to the details of the accident and damage to his vehicle to support his insurance claim.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    REPUBLIC OF THE PHILIPPINES )

    ) S.S.
    X ---------------------------------------------X

    AFFIDAVIT OF DAMAGE TO VEHICLE

    I, ROEL G. VILLANUEVA, of legal age, Filipino, Married and with residence of


    postal address at Purok 189, Brgy. San Isidro, City under oath, depose and state:

    1. That I am the registered owner of;

    MAKE : TOYOTA
    SERIES : Rush 1.5G AT
    BODY TYPE : SUV
    ENGINE NO : 2NRF883875
    CHASSIS NO : MHCE6FF2PIGC013576
    YEAR MODEL : 2019
    PLATE NO : CAS1056

    2. That on May 21, 2020, 9:30 in the evening at 189 Purok, Brgy. San Isidro,
    City of San Fernando, Pampanga, I accidentally hit the concrete pole of our gate while
    moving backward to park the vehicle in our garage.

    3. That when I checked if my vehicle sustained some damages, I noticed that


    there were a dents and scratches in the left rear portion of the vehicle resulting to
    permanent damages to its original paint.

    4. That I am executing this affidavit to attest the truth of the foregoing and in
    support of my claim from my insurance company.

    IN WITNESS WHEREOF, we have hereunto affixed our signature this


    at City of San Fernando, Pampanga.

    ROEL G. VILLANUEVA
    Owner

    SUBSCRIBED AND SWORN to before me this at City of


    San Fernando, Pampanga.

    Doc. No. ; ATTY. RONIEL D. MUÑOZ


    Page No. ; Notary Public
    Book No. ; Commission Expires on 12/31/2020
    Series of 2020. PTR No. 6586743B, 01/14/2020
    IBP No. 106319 (02/13/2020)
    Roll of Attorney No. 63074
    MCLE Compliance No. VI-0009993, 07/03/2018
    A.C. Benoza Law Office, Ground Floor,
    DATA College Bldg., Capitol Blvd.,
    Sto. Niño, City of San Fernando, Pampanga

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