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Affidavit of Accident Leovigilda
Affidavit of Accident Leovigilda
MAKE HONDA
PLATE NO. NEQ-2099
SERIES BR-V- S-CUV
ENGINE NO. L15717335947
CLASSFICATION PRIVATE
CR NO. 436383590
YEAR MODEL 2021
MV FILE NO. 1366-00000424943
3. That sometime on July 13, 2023 at around 1:20 in the afternoon, that I reported at the traffic
bureau, the incident that happen in my car ( Annex “A” ), that in the said report I did not
notice that there was a damage at the rear side of the bumper of the motor vehicle; see
attachment Annex “B”
4. That I am executing this affidavit to attest to the truth of the foregoing facts and to support
my application for the claim of insurance of the said motor vehicle.
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Series of 2023