Republic of the Philippines) S.S.

Marawi City )
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AFFIDAVIT OF DAMAGE TO VEHICLE

I, JOHAYRA C. YSMAEL, Filipino, of Legal age, single, and with office address at
Ministry of Agriculture, Fisheries, and Agrarian Reform, Old Capitol, Matampay, Marawi City,
Philippines, after being duly sworn to in accordance with law, hereby depose and state:

1. That a Toyota Innova Model 2021, Black color, with Plate No. MAU 3835 under
Toyota Financial Services is leased to my name per Land Transportation Office
Certificate of Registration issued on June 09, 2021;
2. That I am a duly licensed driver with Non-Professional Driver’s No.
3. That on May 14, 2023 at around 5:30 in the morning, I was about to go out to buy
pandesal for breakfast, I turned on the engine of the above mentioned car;
4. That while I was slowly driving out of the gate of our compound signaling that I am
turning to the right, a passenger jeepney which was traversing from the right side of
the car hit the lower front on the ride side of the car and cause scratches on the left
front side.;
5. That I was so shocked and for a moment was just left in surprised;
6. That I heard sudden noise and saw the metal gate moving and about to collapse and
fell on the right side of the body of the car causing additional deep scratches;
7. That said passenger jeepney drove away without acknowledging its liability therefore,
a case of ‘hit and run” that it was impossible for me to recognize the its plate number
considering I was left shocked and terrified;
8. That it was so early and no traffic enforcers or person in authority at that time of the
accident;
9. That I am executing this Affidavit to attest to the truth of the foregoing and in support
of the claim against the insurer, People’s General Insurance Corporation for the repair
of the damage caused to the said leased vehicle.

IN WITNESS WHEREOF, I have hereunto set my hand this 23rd day of May 2023,
Marawi City, Philippines.

JOHAYRA C. YSMAEL
Affiant

SUBSCRIBED AND SWORN to before me this 23rd of May 2023, the affiant exhibiting
to me her Driver’s License car bearing License No. M05-14-000655 issued at Marawi City on
May 03, 2022.