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    Affidavit: Parts of The Motorcycle Status

    Uploaded by

    Girlie Anne Gonzales Valdez
    This affidavit was made by AAA, a collector for AAA Corporation. AAA was driving a company vehicle that was involved in an accident. The affidavit details that AAA Corporation owns the vehicle, AAA was assigned the vehicle for work, and an accident occurred while AAA was driving along the national highway. AAA lists the damages sustained to the motorcycle in the accident. The affidavit was executed to attest to the details of the incident and claim insurance for the damages.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Affidavit: Parts of The Motorcycle Status

    Uploaded by

    Girlie Anne Gonzales Valdez
    175 views2 pages
    This affidavit was made by AAA, a collector for AAA Corporation. AAA was driving a company vehicle that was involved in an accident. The affidavit details that AAA Corporation owns the vehicle, AAA was assigned the vehicle for work, and an accident occurred while AAA was driving along the national highway. AAA lists the damages sustained to the motorcycle in the accident. The affidavit was executed to attest to the details of the incident and claim insurance for the damages.

    Original Description:

    Affidavit

    Original Title

    Accident

    Copyright

    © © All Rights Reserved

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    This affidavit was made by AAA, a collector for AAA Corporation. AAA was driving a company vehicle that was involved in an accident. The affidavit details that AAA Corporation owns the vehicle, AAA was assigned the vehicle for work, and an accident occurred while AAA was driving along the national highway. AAA lists the damages sustained to the motorcycle in the accident. The affidavit was executed to attest to the details of the incident and claim insurance for the damages.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    175 views2 pages

    Affidavit: Parts of The Motorcycle Status

    Uploaded by

    Girlie Anne Gonzales Valdez
    This affidavit was made by AAA, a collector for AAA Corporation. AAA was driving a company vehicle that was involved in an accident. The affidavit details that AAA Corporation owns the vehicle, AAA was assigned the vehicle for work, and an accident occurred while AAA was driving along the national highway. AAA lists the damages sustained to the motorcycle in the accident. The affidavit was executed to attest to the details of the incident and claim insurance for the damages.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Republic of the Philippines)

    ____________________ )
    _____________________)

    AFFIDAVIT
    I, AAA, of legal age, single, Filipino and a resident of #____________________,
    Pangasinan, after having been duly sworn to in accordance with law do hereby
    depose and state:
    1. That I am the collector at AAA Corporation, a corporation duly existing and
    organized in the Philippines with principal office address at
    _________________________________;
    2. AAA Corporation is the registered owner of motor vehicle, more
    particularly described as follows:
    Make/Type
    Model
    Plate No.
    Engine No.
    Chassis No.

    :
    :
    :
    :
    :

    As evidenced by copy of the Official Receipt/Certificate of Registration


    which is attached as Annex A to form an integral part hereof;
    3. That the said motor vehicle is assigned to me as service vehicles for
    collection purposes of AAA Corporation;
    4. That sometime on _____________ at around 2:00 oclock in the afternoon, I
    was driving the said motor vehicle along the National Highway at
    ________________ when I figured in an accident;
    5. That at the time of the incident, I am the holder of a drivers license issued
    by the Land Transportation Office under Professional Drivers License No.
    ______________, a copy of which is hereto attached as Annex B to form
    an integral part hereof;
    6. That the motorcycle sustained damages which are as follows:
    PARTS OF THE MOTORCYCLE
    STATUS
    1. Left Flaring
    2. Tail light and Tail Flaring
    3. Rear Handle
    4. Right Engine Cover
    5. Right and Left Hand Cover
    6. Front Finders
    7. Passenger Right Foot Cover
    8. Headlight Cover
    9. Right Flaring
    10.Rear Finders

    Scratch
    Broken
    Scratch
    Broken
    Broken
    Broken
    Broken
    Scratch
    Broken Lock
    Broken

    7. The amount of the damages of the motorcycle is still undetermined;

    8. That I am executing this affidavit to attest to the truth of the


    foregoing statement and for the purposes of claiming insurance
    from the insurer/insurance company.

    IN WITNESS WHEREOF, I hereby affix my signature this ____________ at


    _______________.

    __________________
    Affiant
    License # ____________
    Expires on ____________
    SUBSCRIBED AND
    __________________.

    Doc No. ___


    Page No. ___
    Book No. ___
    Series of 2015.

    SWORN

    to

    before

    me

    this

    ________________

    at

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