REPUBLIC OF THE PHILIPPINES)

DAVAO CITY
)SS.
x---------------------------------------------x

AFFIDAVIT OF TRAFFIC ACCIDENT

I, RESELLE JOY ECO BRITOS, of legal age, Filipino, single, and a
resident of Davao City, after having been sworn to in accordance with law, hereby
depose and say that:
1.

I am the duly authorized driver of a motor vehicle registered under the

name of my employer, PETER DUKE C. REYES, more particularly
described as follows;
Make
Series
Chassis No.
Engine No.
Plate No.
OR No.
CR No.

TOYOTA
AVANZA 1.3J M/T
MHKM1BE1FBK000568
DK96987
LHD -994
258752071
___________

2. On or about 3:00 PM of June 4, 2015, while I was parking near Matina

Town Square, I inadvertently bumped another vehicle thereby
resulting in my front right bumper being dented. By reason of such
incident, the front right bumper of the abovementioned vehicle
sustained damage and needs to be replaced so as to restore the good
condition of the motor vehicle before the incident.
3. I am stating that all of the above for the reason of establishing such
facts and not to perpetuate any fraudulent intent nor to the
commission of the same and forever discharge any person, public or
private, natural or juridical from any liability that may arise from this. I
am executing this affidavit to attest the truth of all the foregoing and
for any other legal purposes this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 13th day of July,
2015, in the City of Davao, Philippines.
RESELLE JOY ECO BRITOS
M06-09-003939
SUBSCRIBED and sworn to before me, in the City of Davao, this 13 th day of July,
2015, affiant exhibiting to me her competent evidence of identity first shown above
written below her name.
ATTY. RALPH JAMES G. LAMAN
Doc No.________
Notary Public
Page No.________
Until December 31, 2015
Book No.________
PTR No. 5259937 12/16/2014
Series of 2015.
IBP No. 964441 12/15/2014
Roll No. 62810MCLE Compliance Exempt 1

1 Recently been admitted to the Bar on May 06, 2014.