A sample template of an affidavit of vehicular accident.
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Grave Misconduct
Cases for Public Corporation
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Republic of the Philippines) Province of ___________) s.s. City of ______________.)
AFFIDAVIT
I, JUAN DELA CRUZ , of legal age, Filipino, single and a resident o _________________________, after having been duly sworn to accordance with law, do hereby depose and say THAT: 1.
&.
I a a duly licensed driver with !river"s #icense _________, which is valid until___________%
'n Aug Augus ustt 1(, 1(, &)1* &)1*,, at arou around nd +: +:) ) o-clo o-cloc c in in the the eve eveni ning ng was driving a otor vehicle owned and registered in y na which is ore particularly described as follows: /ae: 0eries: 2ody Type: 4ear /odel:
/otor $o.: hassis $o.: 3late $o.: /566 $o.:
.
7hile I was driving along the highway street ______________, the aforeentioned vehicle suddenly hit dog and as a result the said vehicle sustained daage at it ______________________________________%
8.
I a e9e e9ecu cuti ting ng thi this s Affi Affida davi vitt to at attest test to to the the trut truth h of t forgoing and in support of the clai against the insurer for th repair of the daage caused to y vehicle. IN WITNES WITNESS S WHEREOF WHEREOF,
sign signat atur ure e thi this 3hilippines.
I have have here hereun unto to se set taf affi fi9e 9ed d ____ ______ ____ ____ ____ ____ __ at ____ ______ ____ ____ ____ ____ ____ ____ __
