AFFIDAVIT

I, Flaviano C. Antoni Jr., of legal age, single, Filipino citizen, and a resident of Barangay
Looc, Mandaue City, Philippines, after having been sworn in accordance with law hereby
depose and state:

1. That, on September 2, 2014 at 8:30 in the morning, I drove my boss to Hall of Justice
Mandaue for his scheduled hearing;

2. That, when we had already reached the façade of the above-mentioned place, my boss
disembarked from the car and I immediately looked for a parking space;

3. That, since the parking area in front of the building was full; I have to go to the back of
the building to look for more parking spaces,

4. That, since the premises have only one entrance and one exit, I have to drive the car out
and re-enter to get to parking space at the back of the building;

5. That, after I re-entered into the premises of the above-mentioned place, the guard
informed me that the parking space at the back of the building was also full;

6. That, I was left with no choice but to move the car back since there was a car before me,
as well as cars parked on my left side and container vans piled on the other side;

7. That, since the guard did not even bother to give pre-caution signals after he
approached and informed me, I have to maneuver my own way to move back the car;

8. That, unfortunately, I didn’t notice an open small iron gate beside the guardhouse as I
was maneuvering the car. As a result, it collided with the rear of the car leaving a dent
on the back door and on the lower part of the back door. A signboard placed near the
gate also left a small scratch on the left side of the fender.

IN WITNESS WHEREOF, I hereunto set my hand this _________________ at Mandaue

City, Philippines.

Flaviano C. Antoni Jr.

Affiant

SUBSCRIBED AND SWORN to before me, this ___________________ at Mandaue City,

Philippines, affiant exhibiting his SSS ID No. 07-22510919-2 establishing his correct identity.

WITNESS MY HAND AND SEAL.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2014