REPUBLIC OF THE PHILIPPINES )

Roxas City )s.s

AFFIDAVIT of ACCIDENT

I, ALVIN LEAL y GUILLERMO, of legal age, married, Filipino and a resident of

Barangay Tamulalod, Dumarao, Capiz, having been duly sworn to in accordance with law, do
hereby depose and say:

1. That I am the driver of Nissan Urvan registered in the name of CAPSU Dumarao
specifically described as follows:

Temporary Plate Number : 060104

Make : Nissan
Series : NV350 URVAN
Body Type : Van
Model : 2016
Engine Number : YD25385747A
Chasis Number : JN1TC2E6Z0005593
CR Number : 246194712
OR Number : 915915895

2. That, I am a holder of a Professional Driver’s License issued by the Land Transportation

Office with License No.: F1212000802 valid until October 19, 2021;

3. That, January 17, 2019 at about 12:10 o’clock in the afternoon I am driving the above
mentioned vehicle. As I am maneuvering the same going out from the campus, I failed to
notice the electric post thereby hitting its concrete pier block which caused damage on the
front right side bumper of the said vehicle, including the turbo intercooler grills;

4. That due to the said crash, the AC cooler was also damage;

5. That, I am executing this Affidavit to attest to the truth of the forgoing and in support of
the claim against the insurer for the repair of the damage caused to my vehicle and the
truth of all the foregoing statements for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this __________________ at

Roxas City, Capiz, Philippines.

ALVIN G. LEAL
Affiant

SUBSCRIBED AND SWORN to before me this _______________in Roxas City,

Philippines, her competent evidence of identity by way of LTO Driver’s License, with number
F1212000802 valid until October 19, 2021.
 AFFIDAVIT of WITNESS

I, IAN LEONIDAS, 28 years old, single, Filipino citizen and resident of Malipayon,
Roxas City, Capiz after having duly sworn to in accordance with law hereby depose and state:

1. That around 7:00 o’clock in the evening of September 24, 2017, I passed by at 3 rd block
together with my two companions after our basketball game. We stopped at the sari-sari
store near Vincent Lacuesta’s (a.k.a. Bonbon) house and brought something;

2. I saw Bonbon having a drinking spree with two others whom I know as alias Totong and
alias Palong. As we passed by them, I and Bonbon exchanged pleasantries and continued
our way home;

3. As we were few meters away, I was able to look back as I heard someone shouting. I saw
Rolando Cereneo a.k.a. Kalbo carrying a wooden block and was asking: “Si Bonbon?”

4. I told my companions to momentarily stop as I sensed that something will happen. I saw
Bonbon who was sitting on the chair got up and came towards Kalbo, as I have observed
they were arguing;

5. Few moments later they distant themselves from each other and was already parrying, I
noticed that a man with long hair came out from the dark portion off the road with his left
hand was behind his back, rushed towards Bonbon;

6. Then I saw him struck Bonbon with a stone which was he holding with his hand and the
three of them started grappling, at that point we backed off;

7. When we were few more meters away, I looked back again and I saw Bonbon already on
the ground with Kalbo on his top and the other man with a long hair;

8. I saw Joey Lacuesta a.k.a Palong came towards the them, however I was not certain what
he did as we already got scared and we ran away;

9. That I do not know the man with a long hair, only later that I learned his name is Joey;

10. I am executing this affidavit for all legal intents and purposes and the same was made
according to our own free will and volition.

TRUTH WHEREOF, I have hereuntoaffixed my signature, this

______________________at Roxas City, Capiz, Philippines.
 IAN LEONIDAS
Affiant

SUBSCRIBED AND SWORN to before me, this _____________________ at Roxas

City, Capiz, Philippines, affiant exhibiting to me his valid identification at Roxas City.