Republic of the Philippines )

City of Cagayan de Oro ) S.S.

DRIVER’S AFFIDAVIT

I, NIÑO JOE G. RIZOL, of legal age, Filipino, married and a resident of 491
Fabrica, Libona, Bukidnon, Philippines, that after having sworn in accordance with law,
hereby and depose that:

1. I am a holder of a Non-Profession Driver’s License with Driver’s License No.

KO3-13-002525, valid until 2024/06/18.

2. On 29 January 2021 at around 9:00 AM, I was driving a vehicle registered

under the name of Toyota Financial Services Philippines (TFSPH), which is more
particularly described as follows:

MV FILE NO. : 0701-00001120062 PLATE NO. : GAO 9693

ENGINE NO. : 2GDC751101 CHASIS NO. : MROJB8DD6L3169387
MAKE : Toyota SERIES : HILUX 2.4L 4X2
YEAR : 2021

3. While I was trying to park the vehicle in reverse inside our staff house at
Valencia City, Bukidnon, I did not notice that I was already near the gate’s concrete wall,
hence, when I continued to drive, I accidentally hit the vehicle against the concrete wall.

4. I immediately went out of the vehicle and checked the whether there was any
damage. It was then I learned that the tail gate, right tail light and rear bumper suffered
some damage.

1. I am executing this affidavit in order to attest to the truth of the foregoing

facts and to comply with the requirement of BPI MS Insurance regarding the insurance
claim of my father in relation to the aforementioned damage and for whatever legal
purpose this may serve.

IN WITNESS WHEREOF, I have hereunto affixed my signature this 01 February 2021

at Cagayan de Oro City, Philippines.

NIÑO JOE G. RIZOL

AFFIANT

Subscribed and sworn to before me this 01 February 2021 at Cagayan de Oro City.
Affiant exhibited to me his Driver’s License No. KO3-13-002525.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2021.