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City of Batangas ) S. S.
AFFIDAVIT
MV File No.
Engine No.
Chassis No.
Conduction No.
Make
Series
Color Red
3. When I came back to my car later in the evening at around 11 o’ clock, I was
surprised to see that my bumper has been hit and damaged.
4. I tried looking for the person or car who caused the damage but no person was
identified. Bystanders stated that it could have been hit by other vehicles parked
in the said parking lot.
5. I executed this statement to attest to the truth of the foregoing matters and for
all legal intent and purposes.
_________________________
Affiant
Non Professional Driver’s License No.
_______________
_____________________