REPUBLIC OF THE PHILIPPINES )

PROVINCE OF CAVITE

AFFIDAVIT OF ACCIDENT

I, THOMAS JEFF N. PINEDA, Filipino, of legal age, and a resident of B25 L15,
Garden Grove, Salitran IV, Dasmarinas, Cavite, after being duly sworn to in accordance
with law, depose and state: That - -

1. I am the driver at the time of accident of a company car issued to JACKY

URBIZTONDO by UNILEVER PHILS. loaned by BPI CENTURY TOKYO
RENTAL CORPORATION, who is the registered owner of a motor vehicle
particularly described as follows:
TYPE : SEDAN
MAKE : HONDA
MOTOR NO. : L15Z12400500
CHASSIS NO. : PADGM6620FV101998
MV FILE NO. : 1301-00000485279
COND. STICKER : DQ3682
C.R. NO. : 224238604

2. Unfortunately, on 17th of September, at around 9: 00 am, while in Airport

Parking Area of NAIA Terminal 2 and while on my way out from the said
premises, a Toyota Vios with plate number TIY341 that was driven by RACHEL
ANN MISTAL with Non-Professional Drivers License #N01-14-002518 and with
residence at 151 Lopez St., Mandaluyong City was rushing towards the exit of
the said area without precaution, collided with the above said car that I was
driving even though I was giving her enough warnings and blowing of horns to
slow down;

3. That it was impossible to maneuver or to prevent the incident on the account of I

would collide the walls of the adjoining structure that would create greater
damage.

4. That such incident would not happen if the driver of another car heed to my
warnings to slow down and give attention to her driving and the fact that she
must give precautions because that such area is a parking area which has a speed
limit of 10-20kph.

5. On account of said accident, the left side of the second door vehicle was damage;

6. I am executing this affidavit to attest to the truth and veracity if the foregoing
statements and for whatever legal purpose the same may serve;

IN WITNESS WHEREOF, I have hereunto affixed my signature this 21st day of

September 2016 in Dasmarias City, Cavite.

THOMAS JEFF N. PINEDA

Affiant

SUBSCRIBED AND SWORN to before me this 21st day of September 2016 affiant exhibiting
to me his TIN#226-694-563-000.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2016