So Sa , } City of Manila ss Al F DAI HICLE |, ANTHONY MARTIN VACA. of legal age. Filipino, and resident of No. 249 Matimtiman $t, Tondo Manila, Philippines, after being swom to in accordance with law. do hereby depose and state: 4. That am the true and registered owner of a certain motor vehicle, that is more particularly described as follows: Model: MITSUBISHI Xpander GLS 1.5 Color: Metallic Red Plate number: NIC 2551 Gentificate of Registration No : 45606893 LTO Official Receipt: 22673344451 Engine No: 4A91KAR6430. Body type: Utlity Vehicle SERIAL No. : MK2LRNC1WPNOO1609 | 2. That on 28 May 2023, at around 10: 00 in the evening, | was parking my car (Xpander) at our designated (pay) parking slot located at Zaragoza Tondo. Manila. It was already dark at that time, hence while i was reversing to fi designated parking space, i did not notice that my rear /back end right portion bumped into a cemented post/obstruction, causing small unnoticeable dents, and big scratches in the paintworks on the rear/ lower back end portion of the body of my vehicle. il 3. Further scrutiny revealed that the lower right rear bumper of our vehicle sustained considerable and noticeable damage. 6. That | am executing this Affidavit to attest to the truth of the foregoing and in support of the claim with the Insurer for the repair of the damage caused to my vehicle and for all legal purposes itmay serve. Jy 15 29 IN WITNESS WHEREOF, | have hereunto set my hand this 15th day of June 2023 in the City of Manila, Philippines. is a MACE SUBSGRIBED AND SWORN TO BEFORE ME this 19th day of June 20: Manila, Philippines by ANTHONY MARTIN VACA who presented his val card: DRIVER'S LICENSE NO4-90-154000 the City of identification ae EDELYN| PNET. GARCIA ! . bury HL or nts DoeNo: 47 SS ee ee a passin 5) She roe 3 Uni 2a 160 asec Se Mana Book No. 07 3 IBPOR No 2esp44/ (8 amuary 203 Series of 2023 PTRN MLA GBs2529) (3 Janay 123/ Manila 1 MCLE Compliance Nx YIENO25506000 February 223