Republic of the Philippines )

Mandaluyong City )S.s

x---------------------------------------x

AFFIDAVIT

I, MS. MARY ANN ESPEJON, of legal age, Filipino, betrothed to

Wilfred Seran Cadigoy, Filipino, Collection Associate of Eastwest Banking
Corporation, and both resident of Phase 3, Block 28, Lot 5, Sta. Barbara
Villas, Silangan, San Mateo, Rizal, after having been sworn on oath in
accordance with law do hereby depose and say that:

1. I am the registered owner of a 2020 Hyundai Reina 1.4GL MT

with conduction sticker number K1 R416 covered by a comprehensive
insurance issued by Prudential Guarantee under agreement with BDOs
Unibank Free Insurance Promo;

2. That on July 5, 2020 at around 2:00PM after my partner, Wilfred S

Cadigoy was driving our vehicle and on our way to Marikina City traversing
Sta. Barbara Villas Road, an uphill grade road, when he was surprised that
a speeding motorcycle traversing downhill suddenly side-swiped the driver-
side of the vehicle. After the said incident he immediately inspected the
damages sustained by the vehicle but the unidentified motorcycle driver
took advantage of the situation and suddenly fled uphill towards the gate of
Sta. Barbara Villas. Upon verification at the gate, they reported that a
motorcycle went towards Marikina City without identifying the plate number
of the said vehicle or its rider;

3. That damages sustained of my vehicle caused by the said

incident were dents and scratches at the driver’s side of its bumper, the left
side fender, side mirror, and its left quarter panel. Immediately we went to
San Mateo Municipal Police Station to report the matter detailing the
incident of what transpired to my vehicle. Such incident was recorded
under Police Blotter Entry No. 478 dated July 5, 2020/2:15PM;

4. I am executing this affidavit to claim for the insurance that will

shoulder the expenses for the repair of the above vehicle and to attest the
foregoing facts.

IN WITNESS HEREOF, I am affixing my signature this ____ day of

July 2020 herein Mandaluyong City.

MS. MARY ANN ESPEJON

Affiant

SUBSCRIBED AND SWORN to before me this ____ d day of July

2020 herein Mandaluyong City.