This affidavit details a car accident that occurred between the affiant and another driver. The affiant was driving their Suzuki multicab when they were bumped by a Nissan while making a left turn. This caused the affiant bodily injuries. The driver and owner of the Nissan have agreed to share the cost of the affiant's medical bills for treating the injuries. As a result, the affiant waives any interest in filing civil or criminal charges against the driver and owner. The affiant signs the affidavit to attest to these details.
This affidavit details a car accident that occurred between the affiant and another driver. The affiant was driving their Suzuki multicab when they were bumped by a Nissan while making a left turn. This caused the affiant bodily injuries. The driver and owner of the Nissan have agreed to share the cost of the affiant's medical bills for treating the injuries. As a result, the affiant waives any interest in filing civil or criminal charges against the driver and owner. The affiant signs the affidavit to attest to these details.
This affidavit details a car accident that occurred between the affiant and another driver. The affiant was driving their Suzuki multicab when they were bumped by a Nissan while making a left turn. This caused the affiant bodily injuries. The driver and owner of the Nissan have agreed to share the cost of the affiant's medical bills for treating the injuries. As a result, the affiant waives any interest in filing civil or criminal charges against the driver and owner. The affiant signs the affidavit to attest to these details.
This affidavit details a car accident that occurred between the affiant and another driver. The affiant was driving their Suzuki multicab when they were bumped by a Nissan while making a left turn. This caused the affiant bodily injuries. The driver and owner of the Nissan have agreed to share the cost of the affiant's medical bills for treating the injuries. As a result, the affiant waives any interest in filing civil or criminal charges against the driver and owner. The affiant signs the affidavit to attest to these details.
I, ___________________, of legal age, married, Filipino, and a resident of
Brgy. _________________________, Philippines after having been duly sworn to in accordance with law do hereby depose and say that:
1. Sometime on _______________ at around ___________ o’ clock in the afternoon
while I was driving my Suzuki Carry Pick-up Multicab with MV no. ______________________and was executing a left turn crossing at the National Road, Brgy. __________________, I was accidentally bumped by a Nissan _____________ with plate number ______________;
2. As a result thereof, I sustained several bodily injuries;
3. The driver of the above-mentioned motor vehicle in the person of
______________ and the registered owner, ___________________, will share on the payment of the hospital bills needed for the treatment of my injuries;
4. In view thereof, I am no longer interested to file any civil or criminal cases
against the driver ______________________ and the registered owner, __________________.
As such, I am executing this Affidavit in order to attest to the truthfulness of the
foregoing facts and for other legal purpose(s) this may serve best.
FURTHER AFFIANT SAYETH NAUGHT.
IN WITNESS WHEREFORE, in order to attest to the truth of the
foregoing, I am hereby affixing my signature to this Affidavit of Undertaking this 11th day of November, 2020 in ___________, Philippines.