Accident
Accident
AFFIDAVIT
I, REMUS C. YAP, Filipino, of legal age, married and a resident of 22D Palawan Alley,
Macaneneng St., Bagong Barrio, Caloocan City, after having been sworn to in accordance with
law do hereby depose and states that:
2. On September 20, 2021, at around 8:00 AM, I drove a SUV with conduction no.
B7F217 registered under the name of BPI Century leased to my wife Marisa Yap, which
such vehicle is more particularly described as follows:
Make : MITSUBISHI
Model : XPANDER
Series : XPANDER GLS SPO
Color : RED METALLIC
Engine No. : 4A91HN3149
Chassis No. : MK2XRNC1WKN076366
3. On said date and time, I parked the above-mentioned vehicle at the parking area of
Caloocan Cityhall where I work;
4. When I came back after our office hours or around 5:00 in the afternoon, I discovered
that the REAR BUMPER, LH QUARTER PANEL was already damaged/broken;
5. The said vehicle was covered by Pioneer Insurance & Surety Corporation under Policy
no. MC-PC-MN-21-0001363-00-D;
5. I have no knowledge of facts indicating as to who was responsible for the said
damages;
6. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other purposes as it may serve.
REMUS C. YAP
Affiant
AFFIDAVIT
3. While the said vehicle was parked outside my brother’s house at 35 NHA-
Mamay Buhangin, Davao City, the same was maliciously scratched by an unidentified
person causing damage in the form of scratch and dent that runs through the side, hood,
fender and side mirrors which was probably perpetrated through the use of softdrink cap;
4. The rear portion of the vehicle has likewise sustained stone marks and kick
marks;
6. I have no knowledge of facts indicating who was responsible for the said damages;
7. I attest to the truthfulness of the above facts and I am executing this affidavit
for whatever purpose it may serve.
SUBSCRIBED AND SWORN to before me this 20th day of February 2002 in the City of
Davao, Philippines, affiant exhibiting to me his Community Tax Certificate with No. 16776270 issued on
February 20, 2002 at Davao City, Philippines.
AFFIDAVIT
I, ALBERTO T. LIM, Filipino, of legal age, married and a resident of Tomas
Monteverde Avenue, Davao City, after having been sworn to in accordance with law do
hereby depose and states that:
Make : TOYOTA
Series : REVO
Color : Amazon Green
Motor No. : 2L-9706329
Chassis No. : LF80-8007938
Plate No. : LEK-130
3. When I came back after two (2) hours, I discovered that there were already
visible scratches on both sides of my car (left and Right portion);
4. Street children roaming around Quimpo Boulevard, Davao City could have
done the scratches on my car, which I presume to have been made by the use of a coin;
5. I attest to the truthfulness of the above facts and I am executing this affidavit in
order to recover insurance proceeds and for other purposes as it may serve.
ALBERTO T. LIM
Affiant
Doc. No. 2
Page No. 2
Book No. VI
Series of 2002
REPUBLIC OF THE PHILIPPINES )
CITY OF D A V A O ) S.S.
x--------------------------------------------------x
AFFIDAVIT
Make : HONDA
Type : Sedan
Color : Cyclone Blue
Motor No. : PH16A-0009358
Chassis No. : PHS04-4A3382
Plate No. : LCY 908
2. On November 19, 2001, while my driver, Mr. Roberto Concoles, was cleaning
the above-described vehicle at my house located at Cabaguio Avenue, Davao City, he
accidentally placed my Aerosol car spray perfume (can type) at the back portion of my
vehicle;
3. On the same day at around 1:00 p.m., I used my car and went to Victoria Plaza,
Bajada, Davao City. I parked my car at the parking space of Victoria Plaza;
4. When I came back after two (2) hours, I discovered that the right portion of my
back dashboard was already damaged and had a big crack. I further discovered that the
Aerosol car spray perfume (can type) had exploded due probably to the intense heat of
the sun;
5. The damage of my back dashboard was due to the explosion of the Aerosol car
spray perfume (can type);
6 I attest to the truthfulness of the above facts and I am executing this affidavit
for any legal purpose it may serve.
ENERIE B. AQUINO
Affiant
SUBSCRIBED AND SWORN to before me this November 21, 2001 in the City
of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No.
18966966 issued on January 17, 2001 at Davao City.
AFFIDAVIT
Make : HONDA
Type : Sedan
Color : Cyclone Blue
Motor No. : PH16A-0009358
Chassis No. : PHS04-4A3382
Plate No. : LCY 908
2. On November 15, 2001, while I was driving the above-described vehicle at the
Buhangin Diversion Road going to Toril, Davao City, a Cargo Truck proceeding
opposite to my direction accidentally hit a stone;
3. Unfortunately, the stone flew and directly hit the right side of the windshield
(passenger side) of the vehicle I was driving which caused a crack and damage to the said
windshield;
4. I attest to the truthfulness of the above facts and I am executing this affidavit
for any legal purpose it may serve.
ENERIE B. AQUINO
Affiant
SUBSCRIBED AND SWORN to before me this November 21, 2001 in the City
of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No.
18966966 issued on January 17, 2001 at Davao City.
AFFIDAVIT
1. On September 9, 2000, at around Eight O’clock in the morning, while I was backing-
up and maneuvering our vehicle inside the parking space of our house, I did not notice a
cemented wall at the front portion;
2. That I accidentally hit the cemented wall which caused damage to the RIGHT HAND
FENDER, HOOD, RIGHT HAND BUMPER and RIGHT HAND SIGNAL LIGHT of the
vehicle;
3. The said vehicle, which is registered under the name of my wife Anita V. Amorado,
is particularly described as follows :
4. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other purposes as it may serve.
SUBSCRIBED AND SWORN to before me this 22nd day of June, 2000 in the City of
Davao, Philippines.
ROGELIO R. AMORADO
Affiant
AFFIDAVIT
I, GIOVANNI S. GALON, Filipino, of legal age, single and a resident of 26-b Santos
Subdivision, Bangkal, Davao City, after having been sworn to in accordance with law hereby
depose and state that:
1. On June 21, 2000, at around One Thirty o’clock in the morning, I was driving a
Tamaraw FX along Anda St. and heading towards the intersection of Rizal and Anda St., Davao
City. The said vehicle is particularly described, as follows :
3. While still in the portion of Anda St. (In front of Clappers KTV Bar and Restaurant), I
decided to make a U-TURN so that I can go back to Bonifacio St., Davao City;
4. When I made a U-TURN, my calculation was rather short since there was a parked
vehicle in front of Clappers KTV and Restaurant. That because of such, I backed-up the vehicle I
was driving;
5. I did not notice that there was a Davao Light Power and Company Electric Posts at the
back, which I accidentally hit;
6. The rear portion of the vehicle, particularly the rear door, suffered minor damage;
7. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other purposes as it may serve.
SUBSCRIBED AND SWORN to before me this 22nd day of June, 2000 in the City of
Davao, Philippines.
GIOVANNI S. GALON.
Affiant
SUBSCRIBED AND SWORN to before me this June 22, 2000 in the City of Davao,
Philippines, affiant exhibiting to me his Community Tax Certificate No. 00919932 issued on
June 22, 2000 at Davao City.
AFFIDAVIT
I, JASON BANGAYAN, Filipino, of legal age, single and a resident of Bo. Obrero,
Davao City, after having been sworn to in accordance with law hereby depose and state that:
1. On July 14, 1997, at around three o’clock in the afternoon, I parked a white Toyota
Corolla GL Sedan in front of the McDonald’s outlet near Victoria Plaza, Bajada, Davao City.
The said vehicle is particularly described, as follows :
2. The above-described vehicle is registered under the name of my father, Dr. Teofilo
Bangayan;
3. After parking the car at the place stated above, I went inside the Victoria Plaza mall to
check on my business;
4. When I returned to the car at around 5:30 P. M., I noticed that there was a dent on the
left rear corner of the car and a deformation on its rear bumper;
5. I have no knowledge of facts indicating as to who was responsible for the said
damages;
6. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other purposes as it may serve.
SUBSCRIBED AND SWORN to before me this 21st day of August, 1997 in the City of
Davao, Philippines.
JASON BANGAYAN
Affiant
SUBSCRIBED AND SWORN to before me this 21st day of August, 1997 in the City of
Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 7932145E
issued on May 23, 1997 at Davao City.
AFFIDAVIT
2. On April 14, 1998 at about 11:30 P.M., I was driving the above-described vehicle and
seated with me was a fellow City Government employee;
3. While we were cruising along the Ma-a Diversion Road going towards the City
Dumpsite, I noticed that that the truck I was driving was on fire;
5. After parking the said truck, I jumped out and poured sand on the fire until a few
minutes later, CENRO personnel helped me in putting out the fire;
6. After due investigation, it was found out that the terminal cable and other wirings of
said truck were grounded which caused an ignition and set the truck on fire;
I attest to the truthfulness of the above facts and I am executing this affidavit in order to
recover insurance proceeds and for other purposes as it may serve.
In witness whereof, I hereunto affix my signature this 25th day of April, 1998 in the
City of Davao, Philippines.
LEOPOLDO R. TORREON
Affiant
SUBSCRIBED AND SWORN to before me this 25th day of April, 1998 in the City of
Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02609851 issued
on March 17, 1998 at Davao City.
AFFIDAVIT
I, THELMA SIMPAO REYES, Filipino, of legal age, single (by annulment) and a
resident of Doñ a Vicenta, Bajada, Davao City, after having been sworn to in accordance with law
hereby depose and state that:
Make : Toyota
Series : Corolla
Type of Body : Sedan
Motor No. : 2E-2410859
Serial/Chassis No. : EE90-9069582
3. On July 19, 1997 at about 11:30 P.M., I parked the above-described in the premises
of Shrine Hill, Matina, Davao City;
4. When I returned, and was about to board said vehicle, I noticed that the front left side
portion of the bumper and the front left parklight of said vehicle were damaged. I have no
knowledge as to who caused the damage;
5. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other purposes as it may serve.
SUBSCRIBED AND SWORN to before me this 24th day of July, 1997 in the City of
Davao, Philippines.
SUBSCRIBED AND SWORN to before me this 24th day of July, 1997 in the City of
Davao, Philippines, affiant exhibiting to me her Community Tax Certificate No. 265983D issued
on January 16, 1997 at Davao City.
AFFIDAVIT
I, RICKY GUTIERREZ QUILO, Filipino, of legal age, married and a resident of New
Matina Gravahan, Riverside, Davao City, after having been sworn to in accordance with law do
hereby depose and states that:
2. I am a driver of the delos Santos family and is assigned to drive a vehicle registered
under the name of Atty. Leo G. delos Santos of 71 Cordillera St., Central Park Subdivision,
Bangkal, Davao City. The aforementioned vehicle is particularly described, as follows :
3. On February 7, 1999 at about 10: 30 A.M., while I was driving the above-described
vehicle along the highway going to Sta. Cruz, Davao del Sur, a YELLOW BUS proceeding
opposite to my direction accidentally hit a stone;
4. Unfortunately, the stone flew and directly hit the left side of the windshield (Driver
Side) of the vehicle I was driving which caused a crack and damage to the said windshield;
5. I attest to the truthfulness of the above facts and I am executing this affidavit for any
legal purpose it may serve.
SUBSCRIBED AND SWORN to before me this 9th day of February, 1999 in the City
of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 16025098
issued on February 9, 1999 at Davao City.
AFFIDAVIT
I, DANILO ANDRADA, Filipino, of legal age, married and a resident of Cotabato City,
after having been sworn to in accordance with law hereby depose and state that:
1. I am the driver of a private vehicle which is registered under the name of TOMAS C.
BUENVIAJE also a resident of Cotabato City. The aforementioned vehicle is particularly
described, as follows :
Make : Honda
Engine No. : PH132-0001833
Serial/Chasis No. : PHSX8-2A1307
Color : Blue
Type of Body : Sedan
2. On July 25, 1997 at about 1:30 P.M., I parked the above-described vehicle in the
parking lot of Victoria Plaza located in Bajada, Davao City;
3. When I went back, and was about to board said vehicle, I noticed that portions of the
QUARTER PANEL, TAIL LIGHT and FRONT DOOR all located at the left side of said vehicle
were damaged. I have no knowledge of facts indicating how the damage was done nor of the
person(s) who caused such acts;
4. I attest to the truthfulness of the above facts and I am executing this affidavit for any
other legal purpose as it may serve.
SUBSCRIBED AND SWORN to before me this _______th day of August, 1997 in the
City of Cotabato, Philippines.
_______________________
DANILO ANDRADA
Affiant
SUBSCRIBED AND SWORN to before me this _______th day of August, 1997 in the
City of Cotabato, Philippines, affiant exhibiting to me his Community Tax Certificate No.
7113322 issued on March 23, 1997 at Cotabato City.
AFFIDAVIT
1. I was married to the late CORAZON G. MARCELO on May 31, 1965 and that this
marriage was blessed with four (4) children, namely, ROBERTO, MA. LOURDES, MA.
ISABEL, and REYNALDO, JR.;
2. On August 03, 1997, my wife, Corazon died in Manila due to natural course/illness;
3. Since January, 1990, my eldest son, Roberto G. Marcelo has been the breadwinner and
the one supporting the needs of our family;
4. As such, I have executed a Special Power of Attorney (SPA) giving him rights to be
my attorney-in-fact to represent me in all transactions, to sign in my behalf, and/or collect any
claims and benefits due us in relation to the demise of my wife, Corazon;
5. I attest to the truthfulness of the above facts and I am executing this affidavit and for
other purposes as it may serve.
SUBSCRIBED AND SWORN to before me this 25th day of September, 1997 in the
City of Davao, Philippines.
______________________________
REYNALDO P. MARCELO
Affiant
SUBSCRIBED AND SWORN to before me this 25th day of September, 1997 in the
City of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 8010778
issued on September 25, 1997 at Davao City.
I, Zacarias S. Ortiz, Filipino, of legal age, married and a resident of Sto. Tomas, Davao
del Norte, after having been sworn to in accordance with law hereby depose and state that:
1. I am the driver of a government vehicle which is registered under the name of the
Municipal Government of Sto. Tomas, Davao del Norte. The aforementioned vehicle is
particularly described, as follows :
Make : KIA
Motor No. : HW-168571
Serial/Chasis No. : KNFTB152V-6347413
Color : White
Type of Body : AMBULANCE
Plate Number: SEN-903
2. On March 19, 1998 at about 11:45 A.M., I was driving the aforesaid government
vehicle along the National Road coming from Davao City towards Davao del Norte;
3. Upon reaching at Km. Post No.1484 (Barangay Lasang, Davao City) and DLPC Post
No. 43180-3335 , I slowed down to avoid hitting another vehicle ahead of the AMBULANCE I
was driving when the vehicle following me failed to apply its brake causing such vehicle to
bump the rear portion of the said AMBULANCE, and as a consequence thereof, caused an
undetermined value of damage of the whole rear portion of such AMBULANCE;
4. The vehicle which bumped the rear portion of the AMBULANCE I was driving was a
Nissan Pick-up Double Cab with Plate Number SCH 483, color green, registered under the name
of National Irrigation Administration (NIA) of Sto. Nino, Carmen, Davao del Norte with CR#
004290 and MVRR # 58963994 and was driven by Fernando Patenio Y Reyes, a resident of
Asuncion, Davao del Norte;
5. I attest to the truthfulness of the above facts and I am executing this affidavit for any
other legal purpose as it may serve.
SUBSCRIBED AND SWORN to before me this 31st day of March, 1998 in the City of
Davao, Philippines.
ZACARIAS S. ORTIZ
Affiant
SUBSCRIBED AND SWORN to before me this 31st day of March, 1998 in the City of
Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 2911516 issued
on January 14, 1998 at Sto. Tomas, Davao del Norte.
JOINT AFFIDAVIT
1. That we both personally know the late MODESTO V. DEMABILDO, he being our
long-time friend;
2. That we know for a fact that he died on October 14, 1940 at San Carlos City, Negros
Occidental;
4. That we are not related to him by consanguinity nor affinity and we are executing this
affidavit for whatever legal purpose this may serve.
IN WITNESS WHEREOF, we have hereunto affix our signature this 21st day of April,
1998 in ________________, Philippines.
Subscribed and sworn to before me this ___ day of April, 1998 at ____________,
Philippines.
AFFIDAVIT
I, REYNALDO SAN JUAN OBRA, Filipino, of legal age, married and a resident of
Davao City, after having been sworn to in accordance with law hereby depose and state that:
3. Unfortunately, the stone directly hit the front windshield of the vehicle I was driving
causing damage to said windshield;
4. I attest to the truthfulness of the above facts and I am executing this affidavit for any
legal purpose it may serve.
SUBSCRIBED AND SWORN to before me this 26th day of June, 1998 in the City of
Davao, Philippines.
LUZ B. PANAGUITON
Affiant
Doc.No.113;
Page No. 23;
Book No. IX;
Series of 1999.
REPUBLIC OF THE PHILIPPINES )
CITY OF DAVAO)SS
x--------------------------------------------------x
AFFIDAVIT
4. I attest to the truthfulness of the above facts and I am executing this affidavit for any
legal purpose it may serve.
SUBSCRIBED AND SWORN to before me this 11th day of July, 1998 in the City of
Davao, Philippines.
ARMAND ALBARRACIN
Affiant
SUBSCRIBED AND SWORN to before me this 11th day of July, 1998 in the City of
Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 8060625 issued
on January 19, 1998 at Davao City.
AFFIDAVIT
I, CARNELL T. TAN, Filipino, of legal age, single and a resident of Davao City, after
having been sworn to in accordance with law hereby depose and state that:
1. On July 29, 1998, at around Ten o’clock in the morning, I parked a Milano white
Mitsubishi Pajero along Villa Abrille Street, Davao City. The said vehicle is particularly
described as follows :
Make : Mitsubishi
Series : Pajero
Motor No. : 4D56A-H4071
Chasis No. : PAEV44WGNVBOO4927
Plate No. : LDK 258
2. The above-described vehicle is registered under the name of my mother, Mrs. Lolita
Tan;
3. After parking the car at the place stated above, I went to a nearby store to purchase car
accessories;
4. When I returned to the car, I noticed that there was a crack/dent on the center front
corner of the car and a deformation of the same;
5. I have no knowledge of facts indicating as to who was responsible for the said
damages;
6. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other purposes as it may serve.
SUBSCRIBED AND SWORN to before me this 29th day of July, 1998 in the City of
Davao, Philippines.
CARNELL T. TAN
Affiant
SUBSCRIBED AND SWORN to before me this 29th day of July, 1998 in the City of
Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 9738145E
issued on May 23, 1998 at Davao City.
AFFIDAVIT
I, ATTY. LEO G. DELOS SANTOS, Filipino, of legal age, married and a resident of
No. 071 Cordillera St., Central Park Subdivision, Bangkal, Davao City, after having been sworn
to in accordance with the law do hereby depose and states that:
1. I am the registered owner of a ISUZU Fuego Pick-up with Motor Vehicle Registry
Receipt No. 08421827 and with Registration Certificate No. CR-41872263. The said vehicle is
particularly described as follows :
4. While we were along the highway going to Sta. Cruz, Davao del Sur, a YELLOW
BUS proceeding opposite to our direction accidentally hit a stone;
5. Unfortunately, the stone flew and directly hit the left side of the windshield (Driver
Side) of my vehicle which caused a crack and damage to the said windshield;
6. I attest to the truthfulness of the above facts and I am executing this affidavit in order
to recover insurance proceeds and for other legal purposes it may serve.
SUBSCRIBED AND SWORN to before me this 9th day of February, 1999 in the City
of Davao, Philippines, affiant exhibiting to me his Community Tax Certificate No. 02720401
issued on January 4, 1999 at Davao City.