Affidavit of Damage to Vehicle Cannibalized Vehicle

(Affidavit of Damage to Vehicle Cannibalized Vehicle)

Affidavit to be submitted to insurance company in support of claim of a vehicle which has been damaged due to theft of parts.

A F F I D A V I T

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:

_____________
Motor No.:_____________
Chassis No.:_____________
Plate No.:_____________

That I am a duly licensed driver with Professional Driver’s License No._______________, which is valid until ______________.

That on _____________, at around_________, I parked the said motor vehicle at____________.

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 ofit, 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)

Affidavit of Damage to Vehicle Hitting a Post while Backing

(Affidavit of Damage to Vehicle Hitting a Post while Backing)

Declaration of damage to a post while backing up an automobile.

A F F I D A V I T

I,____________,Filipino, of legal age,(single / married / widow),and a resident of__________, Philippines, after being sworn to in accordance with law, depose and state:

1. That I am a duly licensed driver with Driver’s License No._____________covered by DLR No.___________, which is valid until___________.

2. That on___________, at around_______, I was driving a motor vehicle owned and registered in my name which is more particularly described as follows:

Make____________ Motor No.:____________
Series:__________ Chassis No.:___________
Body Type:___________Plate No.:_____________
Year Model:___________MVRR No.:____________

3. That while I was slowly backing out of the driveway along__________Street,____________, to park my car at the parking area of___________, the aforementioned vehicle suddenly hit the post of the building from where I was backing out and as a result the said vehicle sustained damage at its __________;

4. That I am executing this Affidavit to attest to the truth of the forgoing and in support of the claim against the insurer for the repair of the damage caused to my vehicle

IN WITNESS WHEREOF,I have hereunto set my hand this___________in___________, Philippines.

AFFIANT

(JURAT)