REPUBLIC OF THE PHILIPPINES)

CITY OF )S.S.

AFFIDAVIT OF AUTHENTICITY

I, ____________________, the “Affiant”, of legal age,

Filipino, with residence address at ________ after being duly
sworn, depose, and say:

1. That I am authorized by _________ to extract the footage

recorded on 06 March 2018 on or about 11:00am by the
Closed-Circuit Television (CCTV) cameras in his house along
the L. Gruet Street and along the Wilson Street, all corner
view and street view of the said street including the complete
view of the intersection of the said streets;

2. That two of the CCTV cameras installed surveil the

intersection between L. Gruet Street, San Juan City and
Wilson Street, San Juan City;

3. That on 6th of March 2018 around 11:00AM, the said CCTV

camera is in operation;

4. That said CCTV camera was able to record the collision

between a Toyota Fortuner with plate number ZEW246 and
a motorcycle with plate number 130103;

5. That I extracted the following video footages on the day of 6th

of March 2018 - - -

a. From NVR Ch3 Main with recorder reference number

2018 03 06 100000 up to 2018 03 06 101059 from the
recorder of the CCTV system (with CCTV camera
codename: NVR Ch3 Main) and as duly save in a media
storage with filename
“NVR_ch3_main_20180306100000_2018030610105
9”.

Page 1 of
2
 b. And from another video footage from NVR Ch4 Main
with recorder reference number 2018 03 06 100000
up to 2018 03 06 101059 from the recorder of the
CCTV system (with CCTV codename: NVR Ch4 Main)
and as duly save in a media storage with filename
“NVR_ch4_main_20180306100000_2018030610105
9” upon the request of the owner of the Toyota
Fortuner, who is Joseph B. Vincoy;

6. I am executing this affidavit freely and voluntarily to attest to

the truth of the foregoing circumstances and the authenticity
of the said video footage for whatever purposes it may serve.

I have hereunto set my hand this ___ of May 2018, at the City
of ________________.

_____________________
Affiant
(Print Name and Sign)

SUBSCRIBED AND SWORN to before me this ___ day of April

2018 in _____________, affiant exhibiting unto me his/her valid
national ID ______________________ issued by
_____________ and valid until ______________.

Doc. No. : _________

Page No.: _________
Book No.: _________
Series of 2018.

Page 2 of
2