Republic 

of the Philippines )
Municipality of Bontoc
Mountain Province                                      
______________________ ) S.S
 

DRIVER’S AFFIDAVIT

I, EDGAR LAMSIS CADOY, Filipino, of legal age, married, and

a resident Poblacion, Kasibu, Nueva Vizcaya, after having been duly
sworn to in accordance with law, do hereby depose and state that:

1. I am the driver of a motor vehicle more particularly identified as

follows:

MAKE : TOYOTA
YEAR MODEL : 2016
SERIES : HILUX 2.8L 4x4
PLATE NO : YT 2075
Engine No. : 1GD0051695
CHASSIS NO. : MR0HA8CD701085931
DENOMINATION: UTILITY VEHICLE
BODY TYPE : PICK-UP

2. I am the cousin of the registered owner of the above-described

vehicle who is JEFFERSON WAKIT BALALONG;

3. I was driving the above-mentioned vehicle on November 8, 2019

at around 9 o’clock in the morning from Guinsadan, Bauko,
Mountain Province going towards Kasibu, Nueva Vizcaya;

4. While traversing a curve portion of the road, the driver of

Immanuel Trans Bus signaled that it is open for the vehicles
behind him to overtake. When I was about to overtake, the driver
of the bus miscalculated its distance, encroached on my lane and
thereby accidentally hitting the motor vehicle I was driving;

5. I noticed that the bus was about to hit me so I tried to evade the
collision as much as possible, making me swerve to the left side
portion of the road. Unfortunately, I hit the riprap;

6. The Bus caused damages to the Toyota Hilux I was driving

specifically dents and scratches at the right side fender and front
right side bumper;

7. On the other hand, my crash on the riprap caused dents and

scratches at left side fender, left side driver’s door and left side
step board of the motor vehicle;
8. The driver/owner of the Immanuel Trans Bus and I entered to a
Memorandum of Agreement whereby we both undertake to not
file cases against each other including a claim against the
insurance of Mr. Balalong;

9. I am executing this affidavit to establish these facts as to the

damage to the car and in support of the claim for
replacement/compensation from the insurer of the said car.

IN WITNESS WHEREOF, I have hereunto affixed my signature

this 12th day of December, 2019, at Bontoc, Mountain Province,
Philippines

__________________________
EDGAR LAMSIS CADOY
Affiant
Professional Driver’s License No. B01-97-029411 issued by
LTO and valid until 05/15/2024

SUBSCRIBED AND SWORN TO BEFORE ME this 12th day of

December, 2019, at Bontoc, Mountain Province, Philippines, affiant
exhibiting his competent proof of identity details of which are
written below his name.

ATTY. ALLEN JOY A. TACTAY

DOC. NO. 399 Notary Public
NC No. 2018-08-20
PAGE NO. 80 Until December 31, 2019
BOOK NO. II P.T.R. No. 9943265/ 01-03-19
IBP No. 097573/ 01-04-19
SERIES OF 2019. TIN 714-432-191-000
Roll No. 71458/ 06-06-2018
MCLE Comp. VI-0019184/3-19-19
Mountain Province