REPUBLIC OF THE PHILIPPINES)

CITY OF MAKATI ) S. S.

A F F I D A V I T

I, ____________________, legal age, single, Filipino citizen and residing

at_____________________, after having duly sworn to in accordance with the
law hereby depose and say:

1. That on _______________, I was aboard my car, a Mits. Lancer

with Plate No. TPS 306, on my way to the office.

2. That at around 7:45 a.m., I parked the car along Valero Street, Makati
City and went to my office at 11th Floor, Solidbank Bldg., 777 Paseo
de Roxas, Makati City.

3. That at around 11:30 a.m., when I went back to the car, I discovered
that the right quarter panel, right lens and trunk lid were damaged.

4. That upon investigation, I found out that the car was hit by an on-
coming vehicle that speed away after the incident.

5. That the bystander who gave the information was not able to jot down
its plate number.

6. That I am executing this affidavit to attest to the truth of the foregoing

facts.

In witness hereof, I have hereunto affixed my signature this ___ day of

_________, in__________.

__________________
Affiant

SUBSCRIBED AND SWORN to before me this ________ day of

___________ , Makati, Affiant exhibited to me his Residence Certificate No.
________, issued at ________ on __________,_______.

Doc. No. : __________

Page No. : __________
Book No. : __________
Series of : __________
REPUBLIC OF THE PHILIPPINES)
CITY OF MAKATI ) S. S.

A F F I D A V I T

I, EUGENIO R. CO, of legal age, Filipino citizen and residing at #2125

Calamba St., Sampaloc, Manila, after having duly sworn to in accordance with the
law hereby depose and say:

1. That on March 9, 2004, at around 5:30 in the afternoon, I was driving a

1997 Mitsubishi Lancer with Plate No. UTH 348, along the North
Expressway going to Sampaloc.

2. That while I was approaching Valenzuela, the windshield was hit by an

object.

3. That as a result thereof, the windshield of the car was broken.

4. That I am executing this affidavit to attest to the truth of the foregoing

facts.

In witness hereof, I have hereunto affixed my signature this 11th day of

March 2004, in Makati Metro Manila.

EUGENIO R. CO
Affiant

SUBSCRIBED AND SWORN to before me this ________ day of March

2004, Makati, Affiant exhibited to me his Community Tax Certificate No.
________, issued at ________ on __________, 2004.

Doc. No. : __________

Page No. : __________
Book No. : __________
Series of : __________