Affidavit of Damage To Vehicl1
Affidavit of Damage To Vehicl1
Affidavit of Damage To Vehicl1
Cannibalized Vehicle)
AFFIDAVIT
I, _____________, of legal age, Filipino, (single / married / widow), and a resident of
_____________, Philippines, after being sworn in accordance with law, depose and state:
That I am the true and registered owner of a certain motor vehicle, more particularly
described as follows:
Make: _____________
Motor No.: _____________
Chassis No.: _____________
Plate No.: _____________
That after an _____________ later, when I returned to the said vehicle, I was surprised
as I arrived to find the _____________ of my motor vehicle stolen and my car
vandalized. There were scratches on the front right side of it, with its paintwork
damaged and needs repair.
That I am executing this Affidavit to attest to the truth of the foregoing and in support of
my claim on the insurance of the said motor vehicle.
IN WITNESS WHEREOF, I have hereunto set my hand this _____________, the City
of _____________, Philippines.
AFFIANT
(JURAT)