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    Affidavit of Damage To Vehicle

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    hillary
    Henry A. Busque was driving his Honda City sedan in Cebu, Philippines on February 18, 2017 when a large 15-wheeler truck hit his vehicle from behind. As Mr. Busque attempted to pass the slow-moving truck, the truck suddenly sped up, colliding with the side mirror and front bumper of Mr. Busque's car. The truck driver fled the scene without stopping. Mr. Busque filed an affidavit on February 22, 2017 to report the incident and damage to his vehicle in support of an insurance claim.

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    Affidavit of Damage To Vehicle

    Uploaded by

    hillary
    123 views2 pages
    Henry A. Busque was driving his Honda City sedan in Cebu, Philippines on February 18, 2017 when a large 15-wheeler truck hit his vehicle from behind. As Mr. Busque attempted to pass the slow-moving truck, the truck suddenly sped up, colliding with the side mirror and front bumper of Mr. Busque's car. The truck driver fled the scene without stopping. Mr. Busque filed an affidavit on February 22, 2017 to report the incident and damage to his vehicle in support of an insurance claim.

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    90960308-Affidavit-of-Damage-to-Vehicle.docx

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    Henry A. Busque was driving his Honda City sedan in Cebu, Philippines on February 18, 2017 when a large 15-wheeler truck hit his vehicle from behind. As Mr. Busque attempted to pass the slow-moving truck, the truck suddenly sped up, colliding with the side mirror and front bumper of Mr. Busque's car. The truck driver fled the scene without stopping. Mr. Busque filed an affidavit on February 22, 2017 to report the incident and damage to his vehicle in support of an insurance claim.

    Copyright:

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

    Affidavit of Damage To Vehicle

    Uploaded by

    hillary
    Henry A. Busque was driving his Honda City sedan in Cebu, Philippines on February 18, 2017 when a large 15-wheeler truck hit his vehicle from behind. As Mr. Busque attempted to pass the slow-moving truck, the truck suddenly sped up, colliding with the side mirror and front bumper of Mr. Busque's car. The truck driver fled the scene without stopping. Mr. Busque filed an affidavit on February 22, 2017 to report the incident and damage to his vehicle in support of an insurance claim.

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    Republic of the Philippines

    City of Cebu

    AFFIDAVIT OF DAMAGE TO VEHICLE

    I, Henry A. Busque, Filipino, of legal age, single, and own Driver of my new
    sedan car with home address Casili Cambiohan Consolacion Cebu, after being duly
    sworn to in accordance with law, hereby depose and state:

    1. That I am a duly licensed driver with Professional Driver's License No. N02-
    90-144465 which is valid until 12 May 2011.

    2. That on 18 February 2017, at around 9:30 pm, I was driving my car, which is
    more particularly described as follows:

    Make: HONDA Engine No.: L13Z1-1400806


    Series: CITY Chassis No.: PADGM16409V000546
    Body Type: SEDAN Plate No.: ZTL177
    MV File No.: 1340-00000409599

    3. That while I was slowly driving along San fernando Street going to dalaguete
    Cebu, a 15 wheeler truck which was on my front lane going to south cebu also, suddenly
    I over took because the big truck was at very slow speed because and it was fully loaded.
    And then when I was over took I gave signals to the big truck I thought he will give way
    just like to the other cars that overtook but suddenly he increased the speed and it was
    night time and the road was not so big thats why I decreased the speed and going to his
    back again and the bad news is our right side mirror and front bumper was hit because
    after I proceeded to his back he change the speed I thought he will stop because it was
    very slow again but it didnt gave signals or anything As a result, the entire right side
    mirror broke off from the said cars and also in my front right side was hit in the back of
    the truck and since the big truck was still moving forward, he increased the speed and left
    us in the road. I try to take the plate number but it was far already.

    4. That the said driver of the big truck drove away without acknowledging the
    incidents, therefore, a case of hit and run that even the plate number of the 15 wheeler
    was impossible to be ascertained;

    5. That there were no traffic enforcers at the time of the accident;

    6. That I am executing this Affidavit to attest to the truth of the foregoing and in
    support of the claim against the insurer for the repair of the damage caused to the said
    company vehicle.

    IN WITNESS WHEREOF, I have hereunto set my hand this 22 day of February,


    2017 at City of Cebu, Philippines.
    HENRY ANDRINO BUSQUE

    SUBSCRIBED AND SWORN to before me, this __ day of February 2010, by


    NERIO M. PEREGRINO who exhibited to me his drivers license with license number
    N02-90-144465 issued at East Avenue, Quezon City, Philippines on May 12, 2008 and
    which will expire on May 12, 2011.

    Notary Public

    Doc. No. ______;

    Page No. ______;

    Book No. ______;

    Series of 2010.

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